In 1988, the global community set out to eradicate polio from our planet. Nigeria is now one of the last-remaining high-risk countries. WHO and UNICEF are currently running a campaign in the country with the aim of providing polio vaccinations to all children under the age of five. However, the terrorist group Boko Haram is currently posing a threat to doctors and vaccination assistants in the northern region. KfW is therefore promoting a satellite-supported programme based on something known as a hit and run strategy. The project is also supported by the Japanease development agency JICA. KfW Stories explains how the programme works.
Accompanied by a team of soldiers, doctors and vaccination assistants move from village to village and hut to hut. Their aim is to vaccinate millions of children in north-eastern Nigeria against polio. Satellites are used to locate groups of people in undeveloped areas. As soon as the time appears right, work begins, but it has to be quick. The groups make their way to the villages, collect all children under the age of five and administer the oral polio vaccine. After about two hours, the team is ready to leave the dangerous area again. The programme applies a strategy nicknamed "hit and run", which means acting as quickly and effectively as possible without becoming victims of the terrorists' violence themselves.
Along with Afghanistan and Pakistan, Nigeria is one of the three remaining countries in the world where polio has yet to be eradicated. The last cases in Europe were identified in the 1990s. Poliomyelitis, or polio for short, is spread by a virus and affects children under the age of five. Most cases of the infection are asymptomatic. However, in one in six cases, the infection attacks the nerves in the patient's spinal cord, leading to permanent paralysis. Should the infection reach the respiratory system, the disease can be fatal. To protect them against this illness, children under the age of five must be administered two oral vaccinations. To stop the virus altogether, at least 95 per cent of the population must be vaccinated against it, even in the remote corners of Nigeria.
"In the past, attacks were aimed specifically at schools and hospitals."
In many countries, development cooperation is associated with risks for aid workers. In our dossier we describe where the dangers are.To the dossier
In many parts of the country, local health agencies are responsible for vaccinations. However, safety and security issues make this approach impossible in the north-east of the country as regions like Borno are currently occupied by Boko Haram. The terrorist group rejects Western values, including health care. "In the past, attacks were aimed specifically at schools and hospitals," says KfW Project Manager Julien Morel. He explains that the area has lacked any regular facilities for a number of years. For this reason, WHO and UNICEF vaccination teams administering inoculation in these regions are accompanied by armed security forces. The danger zones cover around 25 per cent of the country and affect almost 20 million people including around two million children. "We don't know exactly how many people are living where," says Julien Morel. No statistics or even vaccination records are available.
Japan International Agency (JICA) is an incorporated administrative agency implementing the Official Development Assistance of the Government of Japan. In October 2008, JICA merged with the overseas economic cooperation section of the Japan Bank for International Cooperation (JBIC). The new JICA is now able to provide technical assistance, concessional loans and grant aid in a harmonized manner covering areas from infrastructure to grassroots projects. JICA is an important partner of KfW Both banks are part of IDFC, a network of 23 national and regional development banks.
The vaccination teams are working under the Global Polio Eradication Initiative (GPEI) and the Nigeria Polio Eradication Emergency Plan. The aim of the campaign is to halt new outbreaks of polio and eradicate the disease on a global scale. The local project partner is the Nigerian Ministry of Health, represented by the National Primary Health Care Development Agency (NPHCDA). The vaccination teams are set up by WHO, UNICEF and NPHCDA and receive substantial financial support from KfW. KfW has promoted the vaccination programme with EUR 106 million since 2005, with a further EUR 20 million in support planned for 2018. The Japanese JICA also supports the programme.
"We don't know exactly how many people are living where."
Around 370,000 local vaccination assistants have been deployed for this dangerous mission to date. Thirteen staff were killed by Boko Haram in 2013. In addition to terrorist attacks, the vaccination teams have to deal with other difficult conditions. "The infrastructure is very poor; hardly any of the roads are paved. During the rainy season, many of the regions are only accessible by boat," explains Julien Morel, describing access to the remote areas. "The teams often have to cover long distances on foot, carrying their heavy medical equipment with them as travelling by car would attract too much attention."
Read more under the image gallery.
Development cooperation projects in dangerous countries
Poachers slaughter elephants in national parks, eat the meat and make a profit from the ivory. The population of wild animals like rhinoceroses, eastern lowland gorillas or okapis is dwindling, not least due to marauding rebel groups. There are repeated deadly attacks on park managers and rangers in the national parks. The photo on the left shows gamekeeper Erik Mararv, who was shot by elephant poachers. Three of his colleagues died. KfW supports the management of six nature conservation areas, in part, in cooperation with the WWF. “The projects are not just about helping to protect species. They are also about providing more safety and better working conditions for the rangers,” says Karin Derflinger from KfW. Better ranger training, equipment and measures for protecting the animals in their natural environment are supported.
This article is a supplement to the development cooperation photo series that appeared in the autumn/winter 2017 issue of CHANCEN magazine focusing on "Courage".To German edition
The number of Nigerian children infected with polio has declined sharply over the past decade. Spread of the virus was halted completely between July 2014 and July 2016. However, four newly identified cases in August 2016 demonstrated just how important the vaccination programme still is. Every child in every corner of the globe – including Germany – must receive standard polio vaccinations as the virus is still at risk of spreading. "If no new cases are identified by 2019, polio will be classed as eradicated in Nigeria," says Julien Morel. "This would be a real win for humanity."
Published on KfW Stories: Thursday, 28 September 2017
The described project contributes to the following United Nationsʼ Sustainable Development Goals
Goal 3: Ensure healthy lives and promote well-being for all at all ages
Health is the goal, prerequisite and result of sustainable development. Supporting health is a humanitarian requirement – both in developed and developing countries. Around 39 per cent of the worldʼs population lives without health insurance. In poor countries, this amount even exceeds 90 per cent. Many people still die from diseases that are not necessarily fatal with the right treatment, or that could easily be prevented with vaccinations. Strengthening health systems, particularly by making vaccines widely available, can make it possible for us to drive these diseases back and even eradicate them by 2030.
All United Nations member states adopted the 2030 Agenda in 2015. At its heart is a list of 17 goals for sustainable development, known as the Sustainable Development Goals (SDGs). Our world should become a place where people are able to live in peace with each other in ways that are ecologically compatible, socially just, and economically effective.