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Monday, June 28, 2004

  Muslims bring back polio
The new outbreak is a triumph of superstition over
science. The polio cases have spread from the state of
Kano, in the mainly Muslim north of Nigeria. There,
clerics have preached nonsense about the polio
vaccination, claiming it was a western plot to
depopulate Africa by rendering girls infertile, or
even giving its recipients AIDS. Kano’s state
government, under pressure from the militant clerics,
has suspended vaccinations. In January a committee of
doctors and Muslim scholars set up by the state
government said tests had revealed that the vaccine
contained oestrogen, which plays a role in fertility.
The WHO insists that other tests have refuted those
claims. In May, Kano’s government announced that
vaccination would begin again, but this has not yet
happened.

Even if vaccination resumes tomorrow, damage will
already have been done. The WHO says that five times
as many children in west and central Africa have been
infected with polio so far in 2004 as in the same
period in 2003. Though the disease mainly strikes
children aged under five—and leaves them crippled for
life—it can also be carried by people without their
showing any symptoms of infection. Thus, the movement
of people escaping the region’s conflicts is helping
to spread the outbreak. Several of the African states
where it has now appeared have been destabilised by
war, including Sudan, where the Arab-dominated
government has been carrying out a campaign of terror
against Darfur’s black Africans.

It could get much worse. Africa is now approaching the
“high season” for transmission, when the rains make it
easier for the virus to spread through inadequate
sewage disposal. The WHO-led Global Polio Eradication
Initiative maintains that it can still meet its goal
of eradicating new cases by the end of 2005. But to
ensure this, it is seeking fresh donations of $100m,
on top of the $3 billion already invested since 1988.
$25m must come by August to begin a massive
vaccination effort in the autumn. It is looking for
the rich “Group of Eight” countries to lead the way in
providing this money.

It is a tragic setback. The number of cases of polio
worldwide fell from 350,000 in 1988, when the target
date was set, to just 784 last year. The disease was
eradicated from all the Americas ten years ago but it
took until 2002 to declare Europe polio-free. In that
year, there was a temporary resurgence of the disease,
mainly in Nigeria and northern India. But it was
brought back under control with the help of some
intrepid and creative vaccination strategies. In
Somalia—a failed state for over a decade—the
government barely controls parts of the capital. But
even there, teams of vaccinators worked with the
militias of local warlords (ie, the same people who
have rendered the country ungovernable) to set up
roadblocks for forcibly vaccinating travelling
children. The effort there was hindered by the same
rumours about the vaccine (that it is un-Islamic or
gives you AIDS) as in Nigeria, but the WHO
successfully recruited locals to help spread the word,
sometimes hollering from loudhailers on the back of
trucks. Unorthodox perhaps, but Somalia is now
polio-free. So is Congo, another state ravaged by a
war that has claimed 3m lives. The polio-eradication
initiative rightly trumpets its successes in even the
most difficult places.

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