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UNCLAS SECTION 01 OF 02 ABUJA 000876 
 
SIPDIS 
 
STATE FOR AF/W 
DOE FOR GEORGE PERSON 
 
E.O. 12958: N/A 
TAGS: PGOV SOCI TBIO KISL KOCI NI
SUBJECT: NIGERIA: NORTHERN PARENTS REJECT VACCINES 
 
THIS MESSAGE IS SENSITIVE BUT UNCLASSIFIED.  NOT FOR INTERNET 
DISTRIBUTION. 
 
¶1. (U) SUMMARY.  Poloff and PolSpecialist spoke with Dr. Muhammad 
Kabir, professor of community medicine at Bayero University in Kano, 
and Bashir Sanusi, community health specialist with the Kano State 
Ministry of Health, on April 16.  Two themes clearly emerged: 1) 
despite the recent outbreak of deadly diseases like meningitis, 
measles and chicken pox in Kano and other parts of the North, Muslim 
parents still resist immunizing their children; and 2) poor federal 
funding of the medical sector leads to the emergence and reemergence 
of fatal (though entirely preventable and/or treatable) diseases. 
Polio has also reemerged as a major health threat in northern states 
like Kano.  END SUMMARY. 
 
----------------------------- 
PARENTS RESIST POLIO VACCINES 
----------------------------- 
¶2. (U) Kabir and Sanusi maintained that, on the basis of cultural 
sensitivities, some Muslim parents in northern Nigeria continue to 
resist calls to immunize their children against serious diseases, 
noting that parents most often rejected polio immunization.  In 
particular, they noted that skeptical parents wondered why the GON 
sends medical personnel to far-flung communities on polio 
immunization campaigns while it fails to provide medical services 
for more common diseases, including malaria, cholera and typhoid. 
In addition, the mode of delivery of the polio vaccine (orally as 
opposed to an injection), exacerbated these parents' suspicion, some 
of whom otherwise approved of vaccines for their children delivered 
by injection.  Even the fact that the polio vaccine is administered 
free of charge heightens suspicion, they contended, as even poor 
Nigerians must pay for basic drugs to treat common, even fatal, 
ailments like malaria.  These suspicions also fuel conspiracy 
theories and rumors of ulterior motives.  Kabir and Sanusi 
maintained newspaper coverage of a court case pending against Pfizer 
for alleged problems resulting from the testing of a meningitis drug 
in Kano and Jigawa states in 1996, has further heightened concerns 
and provided ammunition to opponents of immunization. 
 
------------------------------------- 
INFLUENTIAL MUSLIMS BEHIND SUSPICIONS 
------------------------------------- 
¶3. (U) Kabir contended that suspicion of polio immunization in the 
North initially had been advocated by two prominent northerners: 
Datti Ahmad, a Kano-based physician turned Muslim cleric and Chair 
of the Supreme Council for Sharia in Nigeria, and Najib Adamu, Emir 
of Kazaure (Jigawa State) and a respected traditional elder.  Ahmad 
and Adamu argued that the polio vaccine was injurious to health and 
urged fellow Muslims to reject the vaccination campaign altogether. 
Considering the amount of influence both a medical expert and a 
traditional elder held in the North, Kabir averred, most northerners 
acceded to claims that the campaign's objectives were anything but 
innocuous or beneficial.  Other religious and traditional leaders 
continue to spread this faulty message.  According to Kabir, the 
average northern Nigerian, already suspicious of mass polio 
immunization, believes the vaccine may be a plan by the West to 
control or eliminate the Muslim population and/or to spread the HIV 
virus among the Muslim population in Nigeria. 
 
-------------------------------------------- 
MENINGITIS, MEASLES, CHICKEN POX ON THE RISE 
-------------------------------------------- 
¶4. (U) Kabir and Sanusi told us that air-borne diseases like 
meningitis, measles and chicken pox are ravaging families and 
communities in the North, leading to hundreds of deaths in Kano and 
elsewhere.  They maintained a source told them as many as 700 people 
have died in Sokoto State as a result of cerebral-spinal meningitis. 
 Hundreds of children have been diagnosed with measles.  (NOTE: A 
recent media report quoted a Nigerian Red Cross official that "an 
estimated five million persons, mostly children are at risk of being 
affected by the health emergencies of measles and cholera" across 
the North.") 
 
-------------------------------- 
EMERGENT AND RE-EMERGENT DISEASES 
-------------------------------- 
¶5. (U) Kabir and Sanusi complained that insufficient immunization 
coverage, corruption and poor funding of the health sector have led 
to the emergence of new infectious diseases (HIV-AIDS, lassa fever, 
 
ABUJA 00000876  002 OF 002 
 
 
ebola virus) and the reemergence of formerly contained diseases 
(polio, tetanus, malaria, river blindness and tuberculosis). 
Predictably, Kabir and Sanusi said, families that refuse routine 
immunization are also the worst hit by these emergent diseases, with 
the exception of HIV-AIDS - the rates of which have declined in 
urban centers like Kano and risen in rural northern areas. 
 
¶6. (SBU) The Ambassador raised immunization issues, and particularly 
our concern about the resurgence of polio, with the Sultan of 
Sokoto, who is senior to most of the emirs in the central and 
northeast regions.  The Sultan said he would be willing to continue 
to voice support for polio immunization, but also wants to ensure 
that the new immunization campaigns address the new strains in the 
virus.  He added that he would "work with the other emirs" to bring 
a better understanding of the issue.  The Ambassador promised to 
send the Sultan the most recent information on polio eradication 
campaigns. 
 
------------------------------------------ 
COMMENT: OPPORTUNITY TO CHANGE PERCEPTIONS 
------------------------------------------ 
¶7. (SBU) Perceptions that polio immunization is either harmful to 
one's health or part of a global conspiracy to eliminate Muslim 
populations pervade northern Nigeria.  Limited access to reliable 
health information undermines USG and Nigerian NGO efforts to 
counter suspicion and carry out successful immunization drives. 
USAID and its Nigerian NGO partners regularly bring together 
religious leaders, including northern imams, to discuss immunization 
and other public health services and are working with stakeholders 
to develop an Islamic HIV/AIDS policy.  Nigeria's preeminent 
traditional Islamic leader, the Sultan of Sokoto (in conjunction 
with other health professionals and religious leaders), has 
expressed an interest in partnering with the USG to promote 
development and improve perceptions toward immunization in the 
North.  To this end, the Sultan has already recorded public service 
announcements promoting public health services, including 
immunizations.  Such initiatives offer our best chances for changing 
public perceptions and combating both emergent and re-emergent 
diseases. END COMMENT.