Northern Nigeria is plagued with many issues, one of them being Polio. Nigeria, along with Afghanistan and Pakistan are the only countries left in which Polio is still endemic. Considering that Polio has been eradicated in most of the world, this fact is quite disheartening and begs the question: Why hasn’t Polio been eradicated in these countries? Unfortunately, the answer to that question is more complicated than simply providing vaccines to the respective populations.
Interestingly, these marginalized populations are Muslim. An interesting fact that was also observed in Uttar Pradesh, India. That is not to say that Islam is a major factor affecting polio eradication. It simply is a commonality shared by different populations affected by the same disease and begs the question: Are these people being marginalized by their government as a result of other cultural and religious tensions? This is the question that I attempt to shed some light on.
Nigeria is arguably divided 50/50 by Christianity and Islam with the south being predominantly Christian and the north being predominantly Muslim. Data shows that northern Nigeria is disproportionately affected by poverty and health issues when compared to southern Nigeria (for instance, higher rates of malaria, cholera, poverty, malnutrition, hunger, etc). To combat these issues, national efforts have focused largely on vertical approaches to these public health issues, which was the approach taken to eradicate polio via the Global Polio Eradication Initiative (GPEI). However, there has been a current shift in global health trends to health systems strengthening as a new public health approach. Also, the failure to eradicate polio in countries such as Nigeria further heightens the need for this approach and the need to comprehend the underlying issues exacerbating the spread of polio.
As mentioned, northern Nigeria is plagued by many issues, most of which is intertwined with the recent insurgence of Boko Haram. It is difficult to use a strictly vertical approach to scale up polio efforts when a huge influence on the community, Boko Haram, continually thwarts these efforts. Due to the presence of Boko Haram, there has been an increase in distrust of the government and deteriorating security, compounded with low levels of education creating a melting pot that is ripe for continued spread of the disease.
Despite these set backs, the number of cases in Nigeria has dropped indicating that is it possible to eradicate the disease once and for all. Also, Nigeria’s successful elimination of Ebola shows that the government is capable is responding swiftly and effectively to public health issues. However in order to replicate this success in polio, Nigeria would need to scale up polio immunization efforts by increasing community engagement and use of community health workers and integrating polio vaccination to other immunization efforts and possibly maternal and child health treatment cascade as a whole.