New cases of polio have emerged in Nigeria. Ahead of World Polio Day, readers of this blog should know that Rotary and other international organizations are stepping up to the plate. In September 2016, Rotary committed an additional $35 million to end polio, bringing its contribution to $105 million in 2016. Two months earlier, the World Bank approved in June 2016 $575 million in additional IDA financing for Nigeria to scale up support for the North-East of the country. This includes $125 million for polio eradication over three years (2017-2019).
The World Bank program document for the additional polio financing notes that multiple obstacles remain to eradicating polio in Nigeria due to a lack of accessibility of some communities in the Northern States. This has led to special measures being introduced, including “(a) ‘hit and run’ interventions where vaccinators use any opportunity to go to difficult areas with the military and leave as soon as all children have been reached; (b)‘fire-walling’ that is, ensuring immunity in areas surrounding inaccessible villages; (c) using local people as vaccinators who can operate without drawing attention; (d) including IPV (Inactivated Polio Vaccine) in routine immunizations activities; (e) having transit bus-stop and market vaccination teams; and (f) ensuring that all internally displaced people residing in camps are covered.”
Despite these efforts, immunization coverage for polio and other vaccines in the North-East still lags far behind the national average. The $125 million additional financing for polio has two components.
- The first component provides $60 million for Oral Polio Vaccine (OPV) and other operational requirements of polio eradication activities. UNICEF will receive $50 million to procure OPV. The additional US$10 million will be used by UNICEF or WHO for a range of activities where funding gaps may be identified, including activities for Immunization Plus Days.
- The second component ($65 million) will help finance routine immunization. The inclusion of a component on routine immunization stems from the fact that it has been shown to be essential for interrupting the transmission of wild polio and thereby completing polio eradication, while also being a critical aspect of improving child and maternal health.
The program document for the additional polio financing is available here.
The difficulties in eradicating polio in the North-East are related in part to insecurity and a broader lack of services and development opportunities. The Boko Haram insurgency has deeply affected the states of Borno, Yobe, Adamawa, Taraba, Bauchi and Gombe, with negative impacts on an estimated 15 million people.
As per the press release for the additional financing package for the North-East, the other components of the package include:
- $75 million for the Nigeria Community and Social Development Project which provides immediate basic social infrastructure and psychosocial support to communities most affected by displacement;
- $100 million for the Youth Employment and Social Support Operation to provide youth, women and the unemployed (especially internally displaced persons, returnees and persons with disabilities resulting from the crisis) with labor-intensive work and skills development opportunities. Cash transfers will also be provided to displaced families and individuals as they return voluntarily and safely to and settle in their old or new communities.
- $50 million for the Third Fadama Development Project that addresses the emergency needs of farmers by improving access to irrigation and drainage services, delivery of agricultural inputs, and contributing to the restoration of livelihoods in conflict-affected households with a focus on women and youth.
- $100 million for the State Education Program Investment Project that supports the return to teaching and learning through financial incentives for teachers who have completed psycho-social training, and provide grants to schools to address their needs as identified by school-based management committees.
- $125 million for the National State Health Investment Project (plus $20 million from the Global Financing Facility) that will help to reestablish health services with a focus on maternal, newborn and child health, nutrition, psycho-social support and mental health. In communities in which health facilities have been destroyed, mobile clinics will be deployed to provide care.
As Rachid Benmessaoud, the World Bank Country Director for Nigeria explained it, “The needs are staggering. Millions of people have lost their livelihoods, schools and health facilities have been destroyed, and the psychosocial impact of the crisis must also be addressed. To help create economic opportunities for the most vulnerable, we have identified a set of initiatives that will have a quick and tangible impact on the population in four priority areas: agriculture, education, health and social protection.”
The World Bank press release on which this blog post is based is available here together with links to other related resources.