Lessons from Polio in Nigeria

At the end of the twenty-fifth year of the Global Polio Eradication Initiative, only three polio-endemic countries remain in the world – a drastic difference from the more than 125 countries struggling to control polio in 1988. One of these remaining countries is one of the most populous in the world: Nigeria.

Located in West Africa, Nigeria has made ongoing efforts to eradicate polio since 1988 as part of the Global Polio Eradication Initiative. As of 2014, the Nigeria Polio Eradication Emergency Plan (NPEEP) has identified six strategic priorities in eradicating polio: enhancing the quality of supplemental immunization activities, implementation of special strategies to reach underserved populations, adoption of special approaches for security challenges areas, improving outbreak responses, enhancing routine immunization and in-between round activities, and enhancing surveillance.

The NPEEP’s efforts have brought about important achievements in the ongoing battle to eradicate polio. In 2013 alone, Nigeria saw a marked reduction of at least 56% in Type 1 wild polio virus cases compared to those in 2012 and witnessed the disappearance of Type 3 wild polio virus with no cases in 2013. However, Nigeria’s six-pronged plan has led to an unexpected outcome in regards to another nearby epidemic.

In recent months, the Ebola epidemic has ravaged countries in West Africa such as Sierra Leone, Liberia, and Nigeria. On July 20th, Nigeria’s Ebola outbreak began when Liberian-American Patrick Sawyer flew into Lagos. Nineteen confirmed cases and one probable case stem from Sawyer’s case, the most recent of which was detected August 31. As of October 20th, the World Health Organization has officially declared Nigeria Ebola-free after having passed the mandatory period of forty-two days after the last confirmed case of the virus being discharged from the hospital.

The World Health Organization Country Representative, Dr. Rui Gama Vaz, highlighted the importance of having an established public health infrastructure system by observing that, “As the most populous country in Africa and its newest economic powerhouse, Nigeria stands at a high risk for the spread of the Ebola virus disease”.

With the construction of public health infrastructure to battle polio, Nigeria has developed a more centralized approach to handling health crises that provided the country a head start over other West African countries. The NPEEP’s strategies such as instituting a centralized National Polio Eradication Emergency Operations Center and improving strategies to reach underserved populations have effectively created a surveillance system that was easily implemented to monitor new Ebola cases.

Many lessons concerning emergency responses and decision-making can be learned from Nigeria’s success in containing Ebola. As the world continues to watch the Ebola health crisis take place in West Africa, Nigeria is a prime example of the importance of public health infrastructure. Development of emergency operations centers and surveillance systems in the rest of the West African countries may lend themselves to further preventing the spread of Ebola. While these lessons from Nigeria may be late to the war on Ebola, they still provide a resounding model of centralized public health infrastructure that may prevent future epidemics from occurring.