PARALLEL DILEMMAS: POLIO TRANSMISSION AND POLITICAL VIOLENCE IN NORTHERN NIGERIA

Abstract

ABSTRACTNigeria is one of three countries where polio continues to be endemic. In northern Nigeria, areas with low levels of polio immunization due to persistent parental opposition as well as implementation and infrastructural problems have contributed to wild poliovirus transmission. Furthermore, political violence associated with Islamic groups opposed to the federal government has also hampered the conclusion of the Global Polio Eradication Initiative (GPEI) efforts. This violence, which began in Borno State and has spread to other parts of northern Nigeria, occurs precisely where poliovirus transmission continues. These two related aspects – parallel dilemmas of low immunization and political violence – confound the conclusion of GPEI efforts in Nigeria. This situation also raises ethical questions both about the final stages of eradication efforts and about military actions to contain ongoing violence. The Nigerian government's attempts to suppress opposition to the polio eradication campaign by threatening non-compliant parents with arrest and by closing down media outlets may frighten some parents into compliance but can also breed resentment and resistance, just as military and police activities, such as house-to-house sweeps and widespread arrests, may encourage sympathy for Islamic insurgents. This situation suggests that the possible solution of one problem – the ending of wild poliovirus transmission – depends upon a solution of the other, i.e. the cessation of violent anti-government activities.