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Murder of nine polio workers in Nigeria threatens eradication efforts

BMJ 2013; 346 doi: http://dx.doi.org/10.1136/bmj.f954 (Published 12 February 2013) Cite this as: BMJ 2013;346:f954
  1. Sophie Arie
  1. 1London

At least nine polio immunisation workers have been shot dead in Nigeria, sparking concern that violent Islamist resistance to vaccination programmes is increasingly threatening efforts to eradicate the disease.

The health workers, all thought to have been women, were killed at two different health centres in the predominantly Muslim Kano region of northern Nigeria. Most were found with bullet wounds in the back of the head, according to local reports. Several others were injured, and one told journalists the attackers tried to lock her and others inside a building and burn them alive.

The attack, on 8 February, is the first major attack on polio workers in Nigeria, which, along with Pakistan and Afghanistan, is among the last few countries where the disease is still endemic.1

No group has yet claimed responsibility or confirmed that the target was polio workers rather than the health centres where they were. But there are close similarities to recent attacks in Pakistan, where at least 16 polio workers have been killed since December.1

Muslim leaders in both countries have long objected to Western led polio immunisation campaigns, claiming that they could be part of a campaign to sterilise the Muslim population or infect them with diseases.

Violence against immunisation campaigns has increased in Pakistan since it emerged that the CIA used a hepatitis vaccination campaign as a way to gain access to the compound where Osama bin Laden was hiding and confirm his location.2

There is suspicion that the Nigerian Islamist group Boko Haram (which translates as “Western education is forbidden”) carried out the killings in Kano inspired by its Pakistani counterparts. The group, which wants Sharia law in Nigeria, has been blamed for the deaths of about 1400 people since 2010.

Heidi Larson, a vaccine expert at the London School of Hygiene and Tropical Medicine, told the BMJ: “The way this happened was almost identical to the Pakistan attacks. I think there’s a statement here that there is a similar sentiment in Nigeria.

“We are so close now [to eradicating the disease] that we need to keep soldiering on. But the single most difficult thing now will be getting the confidence of the polio workers back.”

There are thought to be no more than 1000 cases of polio worldwide. The Global Polio Eradication Initiative said that last year there were 121 new cases in Nigeria, 58 in Pakistan, and 37 in Afghanistan.1

Nigeria had recently increased its efforts, appointing a special polio adviser and opening a new polio operations centre in September 2012. The country has reported no new polio cases since 3 December 2012, according to the World Health Organization.

Unicef and WHO issued a short statement of condolence for relatives and said: “We remain committed to supporting the government of Nigeria and the people of Nigeria in their efforts to better the health and lives of its people.”

Notes

Cite this as: BMJ 2013;346:f954

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