What is being described as the largest public health initiative ever undertaken begins in West and Central Africa October 8. The objective of the four-day campaign is to vaccinate 80 million children against polio in 23 nations.
The synchronized National Immunization Days (NIDs) are the latest efforts in the 16-year old Global Polio Eradication Initiative (GPEI), the second attempt in history to completely rid the world of a disease. The GPEI was launched in 1988 by the World Health Organization, the U.N. Children's Fund, the U.S. Centers for Disease Control and Prevention (CDC) and the service organization Rotary International.
Since then, the number of nations in which the polio virus naturally circulates has dropped from 125 to six. Massive inoculation campaigns such as those now unfolding in Africa have been critical to that achievement.
At an October 2 event in the northern Nigerian city of Kano, Nigerian president Olusegun Obasanjo dosed the 1-year-old daughter of the Kano state governor with the vaccine.
"It is our resolve that all children aged between 1 and 59 months are immunized against this disease," Obasanjo said in press reports. "Let us receive our vaccination teams in our homes, at school, and in public places."
Great symbolism rested in that kick-off ceremony in Kano with the participation of the Nigerian president and the state's governor. Vaccination had been suspended in Kano state for almost a year starting in August 2003 because of fears that the vaccine was dangerous and could harm children.
During that time, the number of cases of crippling polio that occurred in Nigeria leapt five-fold from an equivalent time period when vaccinations were being administered, according to GPEI. Neighboring nations began to feel the effects of Kano's vaccine boycott. Polio broke out in 10 other nations of the region, nations that had previously declared themselves polio free. Genetic examination of the virus causing disease in other nations confirmed that cases appearing in the broader region had indeed migrated from Kano.
Kano leaders, who dropped their objections about the vaccine in July after a new round of safety testing, have now become important boosters of the NIDs. The GPEI considers this resumption of vaccinations in Nigeria a key opportunity to stop cross-border re-infection.
"If we fail to stop polio in Kano, this disease will again spread rapidly and paralyze hundreds of thousands of children throughout the world," said Jonathan Majiyagbe, past president of Rotary, speaking at the Kano ceremony. "Until every child is immunized against polio, no child is safe."
Majiyagbe, who is also a Kano resident, said 3,800 Rotary members will join a volunteer force of nearly 1 million who will help distribute the vaccine across 23 nations in what will largely be a door-to-door campaign.
"It's not like you set up a booth and expect people to show up," said CDC's Dr. Hamid Jafari in a Washington File interview. "That is done, but over and above that what is absolutely critical is that every house in West and Central Africa will be visited. No child should be left out. Every child must be immunized."
Now the director of CDC's Global Immunization Division, the office representing the Atlanta-based agency in the GPEI, Jafari has participated in many NIDs and knows well the hardships and dangers that might face volunteers who join the effort to protect children from disease. "Dust storms, rainy season, areas of conflict -- we have lost vaccinators in insecure areas. I've been in cars that have been stuck in riverbeds. I've had to walk miles from village to village."
Jafari describes NIDs as "massive undertakings" with "enormous logistical challenges," but the volunteers are the most remarkable element in the endeavor. "It's truly inspiring to see the motivation and enthusiasm of the workers on the ground," he said.
CDC will have about 30 representatives -- disease and public health experts -- participating in Africa's NIDs October 8-11. Since 1994, the U.S. health agency has contributed about $330 million to this effort to rid the world of polio.
The following countries will participate in the immunization campaign: Benin, Burkina Faso, Cameroon, Central African Republic, Chad, Congo-Brazzaville, Cote D'Ivoire, the Democratic Republic of the Congo, Equatorial Guinea, Gabon, Gambia, Ghana, Guinea, guinea-Bissau, Liberia, Mali, Mauritania, Nigeria, Niger, Senegal, Sierra Leone, Togo and Sudan.
Nigeria has the world's greatest number of cases in 2004 with more than 570. With 20 cases this year, Niger has the second greatest number of cases in Africa. India has experienced 60 cases of polio so far in 2004, more than any nation save Nigeria.
(The Washington File is a product of the Bureau of International Information Programs, U.S. Department of State. Web site: http://usinfo.state.gov)
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