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12th Meeting of the Expert Review Committee (ERC) on Polio Eradication in Nigeria

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Summary

This report summarises the 12th meeting of the Expert Review Committee on polio eradication in Nigeria, the first to be held in the country following the global Urgent Stakeholder Consultation on Polio Eradication convened in Geneva. It discusses the main findings, deliberations and recommendations of the meeting, and reports on progress made against the 11th ERC meeting recommendations. In attendance were members from the National Primary Health Care Development Agency (NPHCDA), the Government of Nigeria, the World Health Organization (WHO) and members from the "Very High Risk" (VHR) states of Kano, Katsina and Jigawa.



Overall, continued progress was observed across the country in both routine immunisation and strengthening polio eradication, with routine coverage having doubled in the first quarter of 2006 and polio cases declining by 78% during this time. Most notably, a 90% decline in type 1 polio was observed, which is the most virulent and epidemic-prone strain.



Since the last ERC meeting, held in December 2006, steady progress was reported against the last set of recommendations. Of the 19 recommendations, 9 had been fully implemented, 4 were partially acheived and 6 were still in progress. The most worrisome of those recommendations which had not been implemented were: inconsistencies in the incentives offered during Immunisation Plus Days; unclear domestic financing of IPDs; monovalent oral polio vaccine type 3 (mOPV3) had not yet been licensed; and local level microplanning and supervision was still deficient.



The committee reviewed the wild poliovirus transmission and epidemiology in Nigeria, supplementary immunisation activities (SIAs), surveillance and laboratory activities, social mobilisation efforts, and routine immunisation. Following this, the ERC offered forward eight major recommendations:

  1. That federal authorities give special attention to ensuring critical functions such as Supplementary
    Immunisation Activities (SIAs), vaccine procurement and advocacy are continued during the transitional political period that Nigeria is currently facing.



  2. That federal authorities license the use of monovalent oral polio vaccine type 3 (mOPV3) for late July.



  3. That intensified activities should be focused on eradicating type 1 polio in the VHR and high risk (HR) states.



  4. That the SIA and Immunisation Plus Day (IPD) schedule should utilise a changing round of mOPV3 or mOPV1 depending on the epidemiology.



  5. Two national SIAs and four subnational SIAs should be planned for 2008.



  6. The overall quality of training, especially interpersonal communication (IPC) training, should be ensured.
  7. Vaccination teams and supervisors should be working towards an independently monitored coverage benchmark.



  8. The "Reaching Every Ward" strategy for improving Routine Immunisation (RI) must be expanded to cover
    the remaining 40% of legal government areas (LGAs) by the end of 2007.



The 13th ERC meeting was scheduled to take place on September 11-12 2007, and to focus on polio eradication in the very high risk and high risk states. In recognition of this, the ERC proposed the meeting convene in Kano and include participation of representatives of all six VHR and HR states, as well as Sokoto, Kebbi and Borno.