The northern Nigerian state of Kano has agreed to resume polio vaccination early this month, reviving hopes of the World Health Organization that transmission of the disease may be permanently halted by the end of the year.
WHO has issued a warning to travellers to Nigeria to ensure that their polio vaccinations are up to date and has reminded them they need a booster every four to six years, otherwise they can become infected and spread the virus.
Polio has been spreading fast across Nigeria since Kano, the largest of the northern Islamic states, suspended vaccination last August, claiming that the oral vaccine caused infertility and led to the spread of HIV.
Since then the disease has infected and paralysed 26 children in 10 African countries that had been free of polio for about three years because of the success of earlier immunisation campaigns (26 June, p 1513).
The most recent was a case in Sudan's troubled Dafur region, prompting fears that Africa may be on the brink of a major polio outbreak.
After months of negotiations with the country's president, Olusegun Obasanjo, Kano's political and religious leaders agreed to join the polio campaign on condition that oral polio vaccines made in laboratories in Indonesia, an Islamic state, were used.
WHO said the training of staff to administer the vaccine resumed in Kano on 26 June and vaccinations would start again this month. It also said Kano was crucial to the global eradication drive, which was launched in 1988 when 125 countries had endemic polio. Now the disease is endemic in only six countries, including Nigeria.
But while the numbers of cases in the other five—Niger, Egypt, Afghanistan, India, and Pakistan—have been falling steadily, they have increased in Nigeria—boosting the global number of cases this year to 333, compared with 183 this time last year.
“The suspension of immunisation campaigns in Kano has put thousands of children in African countries at risk of polio paralysis,” WHO's director general, Lee Jong-wook, said.
“If the campaigns were not resumed in Kano a 20 year, $3bn [£1.6bn; €2.4bn] effort involving 20 million people to eradicate polio would be in jeopardy,” Dr Lee said.
The eradication campaign is led by WHO, as well as the US Centers for Disease Control and Prevention, Unicef, and Rotary International.