We have come really close to eradicating the deadly disease of polio and so any setbacks have to be viewed with concern. NPR’s Jason Beaubien, who has been doing some excellent reporting on health issues in Africa, says that the recent discovery of two new cases in the northeast of Nigeria (near the border with Chad) has health experts worried because that country had gone for two years without any cases and was on track to be next country to be declared polio-free.

Despite this week’s setback, the world has made incredible progress against polio over the last three decades. In 1988, when the global eradication program began, roughly 150,000 cases were being recorded each year in 125 countries. So far this year, there have been only 21 cases, and those have been confined to Pakistan, Afghanistan and now Nigeria.

As should be no surprise, the finger of blame is being pointed at the Muslim religious zealots in that country who, like in Afghanistan and Pakistan, have been attacking vaccination programs and even killing workers.

The cases are in a volatile part of Nigeria that’s been terrorized by Boko Haram. Boko Haram has publicly denounced polio vaccination as a Western plot. It’s killed immunizers and blocked government health officials from even entering some villages. Nigeria’s health minister says the cases were only detected after a military offensive drove the militant Islamist group out of the area. While Pakistan and Afghanistan have made significant progress against polio this year, insecurity and attacks on vaccinators there also remain the biggest threats to stopping polio in those two countries.

Authorities are fearful that even though there were just two new cases, there may be more undetected cases. The Nigerian government to its credit is launching a massive program to combat this latest outbreak.

The government of Nigeria today launched a massive vaccination campaign in the northern state of Borno in response to news that two children there had been paralyzed by wild-type polio virus.
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Cochi also mentions another factor: complacency. With Nigeria off the list of endemic countries—only Afghanistan and Pakistan remain—eradication leaders have been optimistic they would stop transmission worldwide in 2016, bringing them tantalizingly close to the end of the 28-year $14 billion eradication effort. But there were signs that, after its hard-won success, the government of Nigeria was letting down its guard.
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Because of the 2-year respite, many of the government experts who led the battle to wipe out the virus in Nigeria have moved on. “New people will have to come to grips with the problem,” says Muhammad Pate, the former minister of state for health who headed the country’s polio effort and is now an adjunct professor at Duke University in Durham, North Carolina. The presidential task force on polio eradication Pate used to chair hasn’t convened in at least a year. Although the central government has budgeted money for polio eradication this year, officials have not yet released it, and interest among some local government officials is waning.

Pate worries that people will attribute the outbreak to insecurity alone and “might miss the significance of this as a wake-up call to be more diligent when there are no cases.” That means making sure that each campaign is meticulously executed, monitoring every vaccinator, and using real-time data from one vaccination round to plan the next.

The lesson of this episode seems to be that one must always be on guard against these deadly viruses because they can lie dormant, mutate, and then re-emerge.