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West Africa polio campaign: Interview of Dr Chitou, Head of UNICEF Immunization Programme in Niger

West Africa is coordinating a massive polio outbreak response. A synchronized polio campaign will take place in 8 countries simultaneously - Nigeria, Benin, Burkina Faso, Côte d'Ivoire, Ghana , Mali, Niger and Togo - from 27 February to 2 March and from 27 to 30 March 2009.

Coordinated in Niger by the Ministry of Health, with UNICEF, the World Health Organisation (WHO), the Rotary International and other partners, the campaign aims at reaching more than 4.2 million children under five.

Interview with Dr. Chitou Moudjibi, Head of UNICEF’s Immunization Programme in Niger

Q: In 2006, Niger was removed from the list of polio endemic countries. However, a surge in cases was reported in 2008, since 13 case of Polio were identified: how do you explain this? Is there a risk that Niger is listed again as polio endemic?
A: In 2006, thanks to improved surveillance activities carried out during two years, Nigerien authorities were able to prove that the wild polio virus was no longer circulating in the country. This result was obtained through improvements in the routine immunization and reinforced supplemental immunization campaigns. While routine vaccination aims at providing immunization to every child before its first birthday, supplemental immunization widens protection to groups of children aged between 0 and 5 years, that may have been missed out by routine immunization. These two actions are complemented by surveillance activities to monitor the circulation of the virus.

But the virus still circulates in West Africa, especially in Nigeria, one of the four polio endemic countries in the world. Nigeria is the biggest polio virus reservoir in the world. In 2008, a polio outbrak spread to 7 countries in West Africa. The risk of polio transmission is high. To preserve the health of thousands of children, we must act fast. This is why, following the detection of 13 cases of polio virus in Niger in 2008, the Government decided to engage in this synchronized immunisation campaign which covers eight countries in West Africa.

Q: A synchronised immunisation campaign covering eight countries in West Africa is unheard of. What is the strategy behind this initiative?
By synchronizing vaccinations between countries, we have a bigger chance to reach all children at risk and stop the polio virus in its tracks. It is not the first time that Governments in the region and their partners coordinate simultaneous immunization campaigns, but at this scale - a campaign synchronized in 8 countries, it is a significant event. The idea is to immunize all children aged under 5 at the same time so as to reduce potential risks of missing children due to trans-border movements in a context where high migration movements is prevalent.  

Q: How do you organize the immunization of more than 4.2 million children on the ground?
This campaign is organized according to a plan defined by the Government, with WHO, UNICEF and other partners. Ahaed of the immunization days, awareness activities are organized at the community level, through the broadcast of TV and radio spots and programmes and door-to door communication by social workers. The support of traditional and religious leaders and of local authorities is key to encourage acceptance of the polio vaccination among communities.

During the immunization days, 16,400 teams, each composed of a vaccinator and a volunteer, will go door-to-door, from the health centres to the family houses, to administer the polio vaccine drops. To reach remote, difficult-to-access areas, we have also set up mobile teams, travelling in vehicles, motorbikes or in pirogue (to reach islands).

Q: Were there case of refusals of immunization in 2008? Why? What is your strategy to reduce these cases?
We noted a certain number of refusals in 2008, in various regions of Niger. Communities often wonder why vaccination teams come so often.  Surveys show that reluctance is motivated by a lack of information on the polio vaccination and on the benefits of the anti-polio vaccine. The rumours that we hear is that the vaccine will make children impotent or cause blindness, deafness and other disabilities. That is why awareness-raising sessions and prevention activities organized with the support of traditional and religious chiefs, are so important. In 2008, nearly 2,400 traditional and religious chiefs were trained and are currently engaged in making the campaign a success.







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