Network trying to eradicate polio to be used to tackle H5N1

AFRICA: Africa's response to the first appearance of H5N1 bird flu on the continent may be aided by its fight against an entirely…

AFRICA: Africa's response to the first appearance of H5N1 bird flu on the continent may be aided by its fight against an entirely unrelated infection - polio.

Nigeria, where the flu strain was found in chickens last week, is the focus of a high-stakes effort to eradicate polio from the world.

The work is being done by thousands of vaccinators and surveillance officers equipped with maps. They record every house in every village, and are able to move diagnostic specimens from patient to laboratory quickly and safely.

This extensive public health infrastructure is now mobilising against avian flu.

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A four-day campaign, begun over the weekend, to vaccinate 40 million Nigerian children is being used to deliver a message to thousands of village leaders that people should not touch or eat sick chickens.

"The polio organisation has offered to use all its network to deliver information, and also for surveillance and case detection. We are going to support all kinds of activities to mitigate the impact of avian flu," said Mohammed Belhocine, the World Health Organisation's (WHO) representative in Nigeria.

Should the polio workers become flu fighters, it would not be the first time the eradication campaign paid unexpected dividends. In recent years polio teams have helped rescue earthquake survivors in Pakistan, investigate a lethal outbreak of Marburg virus in Angola, find victims of the rare Crimean-Congo fever in Afghanistan, and deliver malaria-preventing mosquito nets to mothers in Niger.

The versatility of the polio campaign is ironic as well as unanticipated. In the past six years the eradication initiative has missed two self-imposed deadlines to complete a task begun in 1988.

It has suffered setbacks, including a revolt against vaccination in Nigeria's northern states in 2003 that led to a resurgence of polio there, and a temporary reappearance of the disease in 18 other countries.

It has spent $3.2 billion and is chronically short of money. Until a revised strategy and a new vaccine were introduced last year, the 18-year effort was on the verge of unravelling.

Begun by the Rotary International network of clubs, polio eradication has been criticised by some experts as a public health "trophy" that diverts time, money and labour from worse diseases.

However, on the way to its still-unreached goal, the initiative has put in place an infrastructure of people, skill and equipment that can respond quickly to crises in the poorest, most crowded and most inaccessible places.

"It is a network that is in place and that we hope countries will maintain and broaden in scope," said David L Heymann, director of polio eradication at the WHO headquarters in Geneva.

Since the start of 2005, Nigeria has had 770 cases of polio, more than any other country. It is one of four countries where the virus remains endemic or freely circulating. The others are Afghanistan, India and Pakistan.

Nearly all of Nigeria's polio is in its populous, largely Muslim north, which ceased immunising children in 2003 because of rumours that the vaccine would sterilise them. After repeatedly testing the vaccine, switching to supplies made in a Muslim country - Indonesia - and persuading local government and religious leaders to once again support the campaign, mass vaccination resumed last spring.

Two of Nigeria's northern states that were most resistant were Kaduna, where H5N1 was responsible for the death of 40,000 chickens, and Kano state, where other poultry deaths are under investigation.

In December, in the neighbouring country of Niger, the polio "platform" was also used to fight malaria. After each household's children were vaccinated, the mother was given a voucher for a free insecticide-filled mosquito net. Distribution sites were set up so that no one had to travel more than about three miles to redeem the voucher.

Three million children were vaccinated and two million nets were given away.

Last October, when an earthquake struck Pakistan, polio vaccinators were working in the remote tribal areas of North-West Frontier along the Afghan border. Within two hours, 15 teams - each with two doctors in a four-wheel-drive vehicle equipped with a radio or satellite phone - were dispatched to the devastated area.

For three weeks, the teams treated and transported the injured, catalogued the damage and estimated the number of dead. The last two tasks were aided by "micromaps". They are hand-drawn maps of every village that show the location of all dwellings and the number of children in each.