Duodu, Cameron

Fear that a vaccine used by the WHO to combat polio can cause sterility in both men and women, has spurred some Northern Nigerian states to block a crucial vaccination campaign that is aimed at eradicating the disease from West Africa by the end 2004. It reminds me of my boyhood in Ghana.

I bear on my forearm, two deep scars. I can never forget how they came to be there. Our school was vaccinated – I don’t know against what, though I guess it must have been small pox – and I ended up with those two huge scars.

The whole thing was, and continues to be, a great mystery to me. Normally, we were vaccinated on our arms, but this time, they decided to do it on my forearm, after they had looked and found only “scratches” of scars – not proper scars – from my old vaccinations. Of course, they didn’t explain anything to me. Did the lack of scars mean that the previous vaccinations had not “been effective”? They said not a word.

For in those days, all officials of the colonial government behaved like gods. They had been asked to vaccinate us. So they lined us up and cut us up. Case closed.

It was because we suspected that the health authorities were capable of all manners of sleight of hand that many people ran away when the “vaccinators” came into our villages. How did they get their bad reputation? They were apparently out to save our lives. But they were uncommunicative. So the general populace actually believed that they had come to harm us.

We would be there, not affected by any disease, and these people would come. They would go and tell the chief, or a headmaster, that they had been sent to vaccinate everyone. These gentlemen, being part of the incommunicative authoritarian system themselves, would then instruct us to go and get vaccinated. They wouldn’t tell us that smallpox or yellow fever or whatever had been found in other villages, and so we needed to be vaccinated. They would just turn us into fair game.

Yet, if they had taken the time to let us know that we were going to be saved from the type of diseases that had wiped out our army at Kwanyako in the “olden days”; or the illness that left some people pock-marked in the face for life, even if they survived the disease, I am sure we would have welcomed them with open arms. As it was, all the “smart” people in our villages tended to run away from vaccination.

Well, I did not run away because to my young mind, if previous vaccinations had not harmed me, there was no reason to suspect that a new one would. And I have the scars on my forearm – created when the vaccination marks went septic – to remind me daily of what you get when you become too trusting. Did they vaccinate me with unsterilised cutters? Did they cut too deep into the flesh? I shall never know.

I am reminded of these happenings because, right now, Northern Nigeria is embroiled in a controversy over a vaccina-tion against poliomyelitis, the deadly disease that withers the limbs of the people it infects. Fear that a vaccine used by the World Health Organisation (WHO) to combat the dreaded disease can cause sterility in both men and women, has spurred some Northern states to block a crucial vaccination campaign that is aimed at eradicating polio from West Africa by the end of this year.

A 15-year campaign by the WHO has reduced the number of polio cases worldwide to less than 600 a year. But half of this number occurs in Nigeria. Together with its neighbour, Niger, Nigeria is one of the few countries in the world where polio is still classified as “endemic”.

This year alone, the WHO had hoped to immunise an estimated 63 million children against polio in West Africa. If the Northern Nigerian boycott limits the success of the WHO campaign, Benin, Burkina Faso, Cameroon, Chad, Ghana, Togo, and the Central African Republic, could all become vulnerable. Already the source of one infection in Cote d’Ivoire has been traced back to Nigeria.

The opposition to vaccination against polio in such Northern Nigerian states as Kano, Zamfara, Niger and Bauchi, is difficult to overcome – even by the Nigerian federal government – because it is based both on scientific and religious grounds.

According to the Jama’atul Nasril Islam (JNI), the umbrella organisation of Muslims in Northern Nigeria, a medical team sent to India by the JNI to test the vaccines had confirmed fears that the polio vaccine could cause sterility amongst the Nigerian population. The vaccines were also, allegedly, contaminated with toxins.

This allegation of scientific error has been compounded by another allegation, this time of a political nature. The secretary general of the Supreme Council for Sharia in Nigeria, Dr Ibrahim Datti Ahmed, has claimed that investigations by his organisation had found recently declassified US documents which show that America had pursued “a policy, since 1975,” to depopulate African and Muslim countries.

Now, in the atmosphere of suspicion against the US, created amongst many Muslims by the US war in Iraq, plus America’s anti-Bin Laden rhetoric that often incorporates unflattering generalisations about Islam, Dr Ahmed’s words have fallen, of course, on fertile ground. He maintains that the documents showed that the WHO itself had been “actively involved”, for more than 20 years, in the development of “anti-fertility vaccines”, using human chorionic gonadotrophin (HCG) tied to tetanus toxoid as a carrier. This had been passed on to humans through massive anti-tetanus campaigns in Nigeria, Tanzania and the Philippines.

Admittedly, the Supreme Council for Sharia Affairs has a political agenda whose objective is to radicalise Islam in Northern Nigeria. Nevertheless, its charges cannot be dismissed lightly, because in 1996, an American company, Pfizer, was exposed as the practitioner of unethical medical practices whereby children in Kano, Northern Nigeria, were used as guinea pigs in trials of an untested vaccine that was being developed to fight meningitis.

Many parents took their children to the Pfizer trials, expecting them to be cured. But eleven children were reported to have died from the fiasco.

Pfizer denied any wrongdoing and said its trials were officially approved by the Nigerian authorities. But a Washington Post investigation exposed collusion between a Nigerian health official – who exceeded his authority – and Pfizer. The company is being pursued in America by lawyers acting for the parents of the dead children. But so far, the US government is not known to have called the company to account, despite the impression it has created that American companies are not above using unethical methods in their medical research in foreign countries with whom the US has friendly relations.

The Nigerian government’s own role in either not knowing about, or caring enough to stop, the Pifzer experiments, has added fuel to the anger felt by Dr Datti Ahmed and his Sharia Council. He says: “The Council harbours strong reservations on the safety of our population, not least because of our recent experience in the Pfizer scandal, when our people were used as guinea pigs with the approval of the federal ministry of health, and the approval of all the relevant UN agencies.”

To try and calm down the hullabaloo, two separate delegations have been sent to India and South Africa, one by the Sharia Council and another by the federal government, to carry out further tests on the polio vaccine. But this has only added to the confusion that already exists, for the two delegations reached different conclusions.

Dr Haruna Kaita, who conducted the test in India, reported that the vaccines contain “undeclared contaminants that can cause malfunctioning of the testes and cause infertility in women”. The vaccines also harboured “some toxic substances”. But the delegation that went to South Africa described Dr Kaita’s report as “false and alarming”. Its leader, Professor Umaru Shehu, said: “The best methods and equipment were used and no such thing as Dr Kaita described were found in the vaccines.”

The ball is now in the court of the Nigeria’s health minister, Professor Eyitayo Lambo. He must act decisively on the issue. But if he goes the diktat way, it will most certainly not be accepted by the Northern states. In a federation, such as Nigeria, diktats can be counter-productive, as state officials can just simply ignore them.

The issue has even reached the website of the authoritative British Medical Journal, (BMJ), where a debate on it has been raging. One doctor wrote to the BMJ:

“There is an old Igbo proverb which states: ‘Until lions have their own historians, all tales of the hunt shall always glorify the hunter.’ It is therefore simply not good enough for us all to comfortably sit back and energetically blame the rapidly diminishing uptake of the polio vaccine in Nigeria on ‘bad publicity’ alone. What we need to do right now is to swiftly convene a ‘West African Health Conference On Polio’ to seriously ‘thrash out’ all pending concerns … in an ‘evidence-based’, ‘non-vituperative’ and ‘holistically educational’ manner.”

Another doctor wrote: “The fact that a group of people are refusing to take the polio vaccine in Nigeria should not just be dismissed with a wave of the hand because they come from one part of the country and the instructions are coming from their religious leaders.

“There is [a] need for more information on whether it is the same batch that was tested by both groups. The people have a right to fight their cause. They should be assured through adequate dialogue… After all, these people were taking the vaccines before now.”

The situation must be resolved quickly, in order that the vaccination can be resumed. The ravages of polio are so terrible that it is a crime not to eliminate any impediments that prevent people from obtaining treatment that inoculates them against being afflicted with such a truly dreadful disease.

Copyright International Communications Apr 2004

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