VZCZCXRO8941
PP RUEHMA RUEHPA
DE RUEHUJA #1892/01 2050856
ZNR UUUUU ZZH
P 240856Z JUL 06
FM AMEMBASSY ABUJA
TO RUEHC/SECSTATE WASHDC PRIORITY 6553
INFO RUEHOS/AMCONSUL LAGOS 4659
RUEHZK/ECOWAS COLLECTIVE

UNCLAS SECTION 01 OF 02 ABUJA 001892 
 
SIPDIS 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: PGOV EAID SOCI NI
SUBJECT: NIGERIA CONCLUDES FIVE DAYS OF POLIO IMMUNIZATIONS 
 
REF:  ABUJA 1252 
 
¶1.  Summary.  As of July 14, Nigeria had 542 cases of wild 
poliovirus in 15 states, compared to 302 cases in 18 states 
for the same period in 2005.  Nigeria accounted for 82% of 
the world's wild poliovirus cases and for 95% of the cases 
in Africa.  While polio has been concentrated in fewer 
Nigerian states, the number of cases increased significantly 
- leaving uninfected states and the wider region at risk for 
re-infection.  Nigeria carried out an Immunization-Plus 
campaign in 11 northern states on June 29 to July 3.  The 
Expert Review Committee on Immunization said Nigeria's 
National Program on Immunization had improved substantially 
following the installation of new leadership in January 
¶2006.  End summary. 
 
¶2. As of July 14, 2006, Nigeria had 542 cases of wild 
poliovirus in 15 states, compared to 302 cases in 18 states 
for the same period in 2005.  As of July 14, Nigeria 
accounted for 82% of the world's wild poliovirus cases and 
for 95% of the cases in Africa.  While polio has been 
concentrated in fewer Nigerian states, the number of cases 
increased significantly - leaving uninfected states and the 
wider region at risk for re-infection.  The main reason for 
polio's spread within the high-risk states remained the low 
immunization rate of children in northern Nigeria - 
significant numbers of whom have never received a single 
dose of polio vaccine.  The 11 northern high-risk states are 
those in which more than 10% of children were missed by 
vaccinators or received no dose of polio vaccine.  These 
states are Adamawa, Bauchi, Borno, Jigawa, Kaduna, Kano, 
Yobe, Katsina, Kebbi, Sokoto, and Zamfara. 
 
Immunization-Plus Campaign Termed a Success 
------------------------------------------- 
 
¶3. Nigeria's National Program on Immunization (NPI) carried 
out Immunization-Plus Days (IPDs) in the country's 11 high- 
risk states on May 25-29 and on June 29-July 3.  In the 
second IPD campaign, the NPI, in cooperation with the UN 
health agencies, USAID, Rotary and other partners, 
administered polio drops to under-five children and vaccines 
against measles, diphtheria, tetanus, and the whooping cough 
at fixed points and at homes.  On July 2, health workers 
started a house-to-house immunization program to attempt to 
reach all children under-five in the 11 northern states, 
estimated at about 10 million children 
 
¶4. Nigerian health officials termed the June 29-July 3 
campaign a success.  The NPI's Kano State zonal coordinator 
said the house-to-house component "compensated for the low 
turnout" at fixed vaccination sites. Kano State's health 
commissioner said the campaign achieved "substantial 
success" but cautioned that some parents, especially in Kano 
city, did not bring their children to be vaccinated.  He 
termed it "particularly worrisome" that people in Kano 
city's Dala area, which has about 3 million inhabitants, 
"did not show any interest" in the campaign and demonstrated 
"a lot of rejection." 
 
Expert Review Committee's Assessment Is Positive 
--------------------------------------------- --- 
 
¶5. Nigeria's Expert Review Committee (ERC) on Immunization, 
composed of Nigerian and international health experts, held 
its 10th meeting on July 13-14, in Kano.  This was the first 
time the group met outside of Abuja.  It also was the first 
time the 11 high-risk states' health commissioners made 
presentations on the IPD program directly to the ERC and 
discussed the ERC's recommendations for Nigeria.  The ERC 
adopted the IPD approach at its last meeting, in March 2006. 
 
¶6. The ERC assessed that the NPI has made "significant 
progress" in fully consulting and engaging the high-risk 
states in dialogue, planning, and implementation.  The 11 
states' governors seemed to be more involved, as evinced by 
these officials' increased spending on immunization - 
although the governors' level of engagement varied.  The 
relationship between the GON and international donors had 
improved under the NPI's new leadership, in place since 
January 2006.  Overall, Nigeria's immunization efforts had 
improved "radically" compared to those under the NPI's 
former leadership. 
 
Observations on Immunization-Plus Days 
-------------------------------------- 
 
¶7. The ERC had observed much higher engagement and 
"ownership" by the states and local government areas in 
immunization efforts.  Traditional leaders at the highest 
levels were being targeted to increase their involvement, 
but this had not yet translated into real action.  Although 
social mobilization had improved and communities were more 
 
ABUJA 00001892  002 OF 002 
 
 
involved through community dialogue, much more needed to be 
done in a uniform and systematic way.  Also, additional 
child-survival efforts such as insecticide-treated mosquito 
netting and de-worming drugs were ad hoc in nature and left 
too much to the states to decide. 
 
¶8. Anecdotal evidence suggested that citizens' noncompliance 
with and rejection of polio immunizations might be 
decreasing.  This was difficult to ascertain because actual 
data either was not available or was largely unreliable. 
The data obtained through the IPDs, which was better 
monitored and permitted less opportunity for falsification, 
was likely more reliable than that collected through the 
National Immunization Day house-to-house strategy.  Although 
fewer children apparently were immunized against polio in 
the IPD program, this might mean only that more-reliable 
data was being collected.  While many significant 
improvements had been achieved, the ERC cautioned that 
progress must be measured by an actual reduction in the 
number of polio cases. 
 
Expert Review Committee's Recommendations 
----------------------------------------- 
 
¶9. The ERC recommended:  All supplemental immunization 
activities in the high-risk states should follow the IPD 
approach, consisting of a combination of fixed-site and 
house-to-house vaccinations; other vaccines, including 
diphtheria, whooping cough, tetanus, and measles, should be 
made available at fixed sites; additional care such as 
vitamin A and anti-worm treatments should be given at 
appropriate intervals, and yellow fever and cerebrospinal 
meningitis vaccines could be administered when necessary. 
 
¶10. The September IPD round will be carried out in 11 to 19 
states, and cerebrospinal meningitis inoculations will be 
administered if the vaccine is available; the October 
measles and oral-polio vaccine round will be held in 17 
states in Nigeria's southern zones; the November IPD round 
will be carried out in selected high-risk areas; and in 
December, a full national immunization round will be carried 
out, as well as the IPD approach in the 11 high-risk states. 
The ERC suggested that the NPI carry out two full national 
rounds and one large-scale sub-national round; that the NPI 
continue the IPD approach in selected states; and that the 
NPI carry out the first round as early as possible in 2007. 
The ERC next will meet in November 2006.  It will review the 
progress made, as well as adopt a strategy for 2007. 
 
¶11. Embassy Abuja delivered to the Nigerian Ministry of 
Foreign Affairs on June 16 the letter on polio in Nigeria 
from Secretary of State Rice to President Obasanjo.  Embassy 
Abuja has not received a reply to this letter. 
FUREY