OBITUARY: Polio, the virus that left Nigeria for Mecca, dies after 9bn vaccine doses

In February 2005, a five-year-old Nigerian boy was reported to have travelled from northern Nigeria to Mecca, Saudi Arabia, where he was diagnosed with the wild poliovirus after losing his limbs to paralysis a few months earlier. This happened just before over two million people from six continents converged on the Islamic holy city for the annual pilgrimage. Before then, Saudi Arabia had been polio-free for 10 years, and only six countries in the world still had the virus. But this resurgence meant the Kingdom, and possibly the world, was in trouble.

Though only one in 200 infections leads to irreversible paralysis, but anywhere the world sees this paralysis, there is a high chance that many other people around were also carrying the virus. Saudi knew this, and immediately began immunisation of hundreds of thousands of people. In three months, 800,000 people had been vaccinated. But the story does not end there.

The World Health Organization (WHO) traced this polio case to Kano, one of the most populous states in Nigeria, where political and religious leaders had brought a halt to the vaccination programmes, claiming that the vaccines were contaminated and made to reduce fertility in the region.

“We believe that modern-day Hitlers have deliberately adulterated the oral polio vaccines with anti-fertility drugs and contaminated with certain viruses which are known to cause HIV and AIDS,” Datti Ahmed, a Kano-based physician who led the Supreme Council for Sharia in Nigeria (SCSN), said in 2003.

This was the sentiment in Kano, Zamfara and Kaduna state. According to News24, government officials in Kano said their own scientists tested the vaccines and found trace amounts of oestrogen and progesterone, female sex hormones which the officials feared could cause infertility.

WHAT IS POLIO? WHERE IS IT FROM?

Poliomyelitis is a highly infectious disease caused by a virus. It invades the nervous system, and can cause total paralysis in a matter of hours. It is transmitted from person to person. The WHO says the initial symptoms are fever, fatigue, headache, vomiting, stiffness of the neck and pain in the limbs.

One in 200 infections leads to irreversible paralysis and among those paralysed, 5percent to 10percent die when their breathing muscles become immobilized. Yes, polio kills.

Historians suggest that polio is as old as civilisation itself; Egyptian paintings dating back many centuries show healthy people with withered limbs as is the case with some polio survivors. The virus has since affected every continent of the world.

In 1988, World Health Assembly adopted a resolution for the worldwide eradication of polio. It also launched the Global Polio Eradication Initiative (GPEI), which has seen the polio cases reduce by over 99 percent since then.

THE POLIO EXPLOSION

From two cases in Mecca in 2005 and a few in six countries, polio spread to 20 countries — owing to the vaccine distrust that exists till date.

According to WHO, from 2003 to 2006, an outbreak in northern Nigeria led to national and international spread of the disease, “eventually re-infecting 20 previously polio-free countries, causing outbreaks in places as far away as Indonesia and Yemen, and resulting in 1,475 cases in these 20 countries”.

In 2002, there were only 220 cases of polio recorded in Nigeria, suggesting that the country of about 150 million people at the time was gradually conquering polio. But the setback of 2003 saw cases rise to 782 by 2004.

About half of the global burden was in Nigeria.

BILL GATES INVESTS 100% MORE THAN REQUESTED

In 2008, polio cases in Nigeria almost tripled, causing the need for increased investment. But at the next budget meeting for the Gates Foundation, the polio team asked Bill Gates for $200 million to kick polio out of Nigeria for good.

Bill, in his response to their request, said: “I think you just asked for the most you thought you could ask for, you did not ask for what it is going to take to have a high probability of success.”

He doubled the money and approved $400 million to get polio out.

Money was not going to solve all the problems. The Gates found that vaccinators had missed some Nigerian settlements because those places were not captured on the map. The maps they had were hand-drawn ones by the British, as far back as 1945. Hence, it was easy to miss many hard-to-reach, high-risk border communities.

To solve this problem, Gates and his team used “high-resolution satellite imagery, algorithms and increased computing power” to create detailed maps of Nigeria. Missing out on villages became a thing of the past.

The numbers began to drop, and went as low as 21 in 2010.

While this seemed like a big feat, India, the country with over a billion people recorded no case of wild poliovirus, but WHO waited till 2014 before declaring the country polio-free. If India could do it, any other nation could. This was a big leap forward.

In Nigeria, Gates became friends with Aliko Dangote, and both men began investing in healthcare in Nigeria, and eradicating polio together in the country.

ENTER BOKO HARAM AND THE TERRORIST-POLIO DYNAMIC

By September 2010, members of a new terrorist group in Nigeria broke into a prison in Bauchi, releasing over 100 inmates, who would go on to continue as soldiers for this insurgent group.

They took over small communities and mounted roadblocks, and made it impossible for vaccine volunteers to reach some towns in northeast Nigeria.

They were not alone, the terrorist-polio dynamic was also playing out thousands of miles away in Pakistan and Afghanistan, where the Taliban had also restricted the vaccinators, ensuring that these three countries were the last in the world with the virus.

In 2012, things went from bad to worse, a roadside bombing killed polio vaccinators in Nigeria. According to the Bill Gates documentary, Inside Bill’s Brain, two men used a four-year-old as a decoy to track down and kill volunteers. One of them was a mother of eight. Many told Gates to drop this dream of kicking polio out of Nigeria.

“It wasn’t worth it,” they said.

Gates did not give up, he made a big announcement in 2013 that his foundation and some organisations will eradicate polio in six years. This plan, called “the endgame strategic plan,” would require $6 billion. Gates had to reach out to billionaire businessman Warren Buffet for help.

‘DIES’ IN AFRICA AFTER 9 BILLION DOSES

On August 25, 2020, Nigeria and indeed Africa was certified polio-free. Moeti Matshidiso, WHO regional director for Africa, who was one of the officials to declare the news said the victory over polio in Africa was coming after nine billion doses of vaccines were deployed.

“Today, we reap the fruits of a promise made 24 years ago by African Heads of State to future generations. It has been a remarkable journey of perseverance, of innovation and of sacrifice,” she said.

“In working towards this goal, together, we have averted 1.8 million cases of paralysis among children and in doing so, deployed 9 billion doses of the vaccine.”

Matshidiso’s father was one of the health workers who certified Africa free of smallpox 40 years ago. For her, she stands in her “late father’s footprints”.

As Gates said on the day of Africa was declared polio-free, “we are not done yet”. While the virus may have been kicked out of Africa in accordance to Nelson Mandela’s dreams when he launched the launch of the “Kick Polio Out of Africa campaign” in 1996, the world is not free yet.

The world still has to beat wild polio in Pakistan and Afghanistan because “until polio is gone everywhere, it can still return”. But as far as Africa is concerned today, August 25, 2020 will be forever remembered as the day the wild poliovirus “died” in Africa.