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23 Jun 2004 07:25
The largest epidemic of polio in recent years has broken out in Nigeria and is spreading across central and western Africa, threatening 74-million children with the paralysing disease and jeopardising hopes of eradicating it from the world by the end of the year.
In the state of Kano in Nigeria, which is at the centre of the outbreak, doubt over vaccine safety has led to the suspension of immunisation, and 257 children have now been paralysed by the disease, the World Health Organisation said on Tuesday.
Polio is now being exported to neighbouring countries, including Sudan, where a child in Darfur has been infected by the Nigerian strain of the virus.
There are now 22 countries affected, 10 of which were free of polio last year.
“It has spread as far south as the Central African Republic, so it is on the border with the [Democratic Republic of] Congo, which has been one of the great successes of the polio eradication programme,” said Bruce Aylward, the global coordinator of the WHO-led programme.
“We’re seeing five times the number of cases in west and central Africa that we did last year—301 as opposed to 58. We could see thousands of children paralysed across west and central Africa at a time when the virus should be eradicated.
The countries it is spreading into have very weak immunisation programmes, reaching only 50%.”
Kul Gautam, deputy director of Unicef, said the Darfur case was “the latest tragedy to hit children in a region beset with multiple tragedies.
“Too many children across the region are defenceless against the disease. We are on the verge of a totally unnecessary public health tragedy. This has all the potential to become a humanitarian crisis.”
The programme plans a huge synchronised immunisation drive across 22 African coun tries in October and November. But it will need a lot more money.
“This is going to require an additional $100-million (about R630-million) over the next two years, and $25-million (about R157-million) by August,” said Dr Aylward.
Since 1988, more than $3-billion (about R19-billion) has been raised and spent on attempts to rid the world of polio.
Britain announced on Tuesday that it would make immediately available this year’s Â£14-million (about R161-million) contribution to eradicating polio.
“I urge all donors to turn their pledges into cash and call on the international community to commit the political and financial resources necessary to eradicate polio once and for all,” said Gareth Thomas, minister for international development.
In Kano, polio immunisation was suspended last year after religious leaders claimed that the vaccine would make women sterile and rumours spread that it was a western plot to reduce the number of Muslims.
State leaders said they would undertake their own investigation into the safety of the vaccine. They reported in January, saying they had found traces of the female hormone oestrogen, which could affect fertility. Tests elsewhere have not replicated the findings.
In February, the federal government sent politicians, scientists and religious leaders abroad to investigate how the vaccine was produced and tested.
In May, there appeared to be a breakthrough when officials announced that they had received a safe vaccine from Indonesia, a Muslim country. Immunisation has not yet resumed, however.
David Heymann, WHO representative on the eradication programme, said that the epidemic in Kano meant that most people now wanted their children immunised. “Most, if not all, of the concerns that have been raised in terms of immunisation and safety with the vaccine have been resolved,” he said.
It was not possible to stop travel between Nigeria and its neighbours, said WHO experts. Those infected are in rural areas, and many travel regularly across borders. The three most heavily reinfected countries are Chad, Burkina Faso and Ivory Coast.
“Telling people not to travel to these areas would not be effective,” said Dr Heymann. - Guardian Unlimited Â
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