Polio in Nigeria: A review of the situation and problems hindering its elimination

Nigeria is important to the polio eradication for the fact that a large proportion of importation into polio-free countries following elimination have been from Nigeria. It is the only country endemic for both Wild Polio Virus 1 and 3 as well as circulating Vaccine Derived Polio Virus type 2. We reviewed the pertinent literature including published and unpublished, official reports and working documents of the Global Polio Eradication Initiative (GPEI) partners as well as other concerned organizations. The literature were selected based on the following criteria: published in English Language, published after year 2000, relevant content and conformance to the theme of the review and these were sorted accordingly. The challenges facing the Polio Eradication Initiative (PEI) in Nigeria were found to fall into three categories viz failure to vaccinate, failure of the Oral Polio Vaccine (OPV) and epidemiology of the virus. Failure to vaccinate resulted from insecurity, heterogeneous political support, programmatic limitation in implementation of vaccination campaigns, poor performance of vaccination teams in persistently poor performing Local Government areas and vaccine refusals in Northern Nigeria. Sub optimal effectiveness of OPV in some settings as well as the problems of VDPVs associated with OPV type 2 were also indicted. Some of the innovations meant to manage the threats to the PEI include a strong government accountability frame work, change from type 2 containing OPV to monovalent and bi valent OPVs for supplementary immunization activities, sustaining environmental surveillance in key states (Sokoto, Kano and Borno) with an overall improvement in SIA quality. There has been an improvement in coverage of routine immunization and vaccination campaigns, which has been reflected in reduction in the number of new cases; 6 in total for 2014. However, the last mile remains and there is need to further improve and complete the journey towards polio elimination.