ABUJA, Nigeria – For years, Nigeria’s well being care community has been rated among the many worst on the planet: a 2018 research within the Lancet of world well being care entry and high quality ranked Nigeria 142nd out of 195 international locations.
However current enhancements to the well being care infrastructure within the combat to finish polio, together with a decentralized illness management community and improved vaccine storage, imply the nation just isn’t solely on the point of eliminating this debilitating sickness but in addition higher outfitted to combat different lethal ailments corresponding to measles and Ebola.
“The polio system improved the logistic and materials system, each from the nationwide to the state to the native authorities, as much as the final man,” says Ngozi Nwosu, nationwide coordinator for the polio transition planning committee of the Nationwide Main Well being Care Improvement Company.
Among the many techniques now in place are a sequence of Emergency Operation Facilities (EOCs) throughout the nation – centralized workplaces made up of well being consultants from completely different assist companies and authorities well being employees.
Whereas they’re overseen by a nationwide EOC in Abuja, workplaces in every state are accountable for coordinating immunization packages and gathering information at a neighborhood degree, which means they’ll rapidly reply to illness outbreaks with out ready for a federal response.
“For every state there have been … a bunch of skilled well being employees that have been additionally out there to take care of points as they arose,” Nwosu says. “In order that the problem of paperwork, writing letters, coming to Abuja, it was simply overturned.”
The primary EOCs have been established in 2012 with funding from the Invoice and Melinda Gates Basis. Two years later, the EOC system confronted arguably its largest take a look at to this point: in July 2014, as a large Ebola outbreak unfold throughout West Africa. Nigeria reported its first case in Lagos – the affected person and 7 others died from the illness.
However inside three months, the nation had largely contained the illness, in what the WHO known as “a bit of world-class epidemiological detective work.” Well being consultants say the techniques put in place by polio eradication efforts, significantly its decentralized, rapid-response construction, was essential.
“Once we had Ebola in Nigeria, it was these polio (EOCs) that helped reply,” says Omotayo Bolu, immunization director on the Middle for Illness Management in Nigeria. “Polio has been in emergency mode for thus a few years … they know what to say, what to do, the place to look, easy methods to organize the groups.”
The polio program has additionally helped enhance vaccine storage: Based on the CDC, vaccines should be saved at a median temperature of 40F (5C) to be efficient.
Sustaining this temperature generally is a problem in underdeveloped communities like Kano, within the nation’s north. However because of funding for polio eradication, town’s chilly cupboard space tripled final 12 months.
“We did not have the capability to retailer vaccines,” says Sharif Yahaya Musa, immunization officer on the Kano EOC. “Now we will maintain all of the vaccines, even the brand new vaccines. The constructions we have now for polio we use for different ailments, in information, in vaccines, in no matter.”
Regardless of these main advances, nonetheless, challenges stay.
Though wild polio seems on the verge of defeat, well being employees at the moment are dealing with a surge in circumstances of what’s generally known as vaccine-derived polio. Most of Nigeria has been utilizing an economical polio vaccine delivered orally, which makes use of a weakened type of the reside virus, as a substitute of the injectable vaccine which comprises a killed model however is costlier and tough to manage.
In uncommon circumstances, the virus from the oral vaccine can mutate within the setting, and infect individuals the place immunization charges are low, a substantial danger in a rustic the place well being care stays stymied: whereas there have not been any wild polio circumstances since 2016, there have been at the very least 23 circumstances of vaccine-derived polio as of July this 12 months.
This pressure of the illness is far much less virulent, in keeping with well being consultants: whereas one in 200 individuals contaminated with the wild virus are more likely to change into paralyzed, with the vaccine-derived model, that price is 1 in almost three million.
“Should you ask me from a worldwide polio standpoint, as an eradicator, I am probably not involved with (vaccine-derived polio),” says Anis Siddique, UNICEF’s polio chief in Nigeria. “However as a public well being (problem), as a caregiver to youngsters, I’m very involved.”
Reporting for this story was supported by a press fellowship from the U.N. Basis.