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Consider that Nigeria, infamous for its anti-vaxx campaigns leading to polio outbreaks, has lessons for Americans can be shocking.
However, as measles cases in the United States peak after the proclamation of the elimination of the disease in 2000, US public health officials have looked for ways to address this problem.
As a researcher in religious politics and health, I believe that Nigeria's highly mobilized efforts to eradicate polio can teach America how to reverse the current measles trend and strengthen its public health infrastructure. In collaboration with international partners, Nigerians fought disinformation, the suspicion of vaccine science, and the religion-based boycott of zero polio on the African continent in 2003 and virtually polio-free in 2019.
When creating the Global Polio Eradication Initiative (GEPI) in 1988 with the aim of eradicating it completely by the year 2000, several countries could not reach the # 39; goal.
Nigerians understood that simply ostracizing religious communities would not work.
India still needed 14 years, while Nigeria, Pakistan and Afghanistan faced strong internal opposition to vaccination. GPEI's huge 2003 campaign took place shortly after Shari'a (Islamic Law) was introduced by the northern states of Nigeria. Some clerics and politicians have encouraged a vaccination boycott, citing contaminants that may reduce the Muslim population and mistrust of the government. The United States now faces the same resistance. Orthodox and Hbadidic anti-vaxx Jews are under scrutiny in New York and Rockland County, but the New York Times has also uncovered resistance among Muslims, Catholics, Waldorf school parents, and Muslims. Other cultural dissidents.
Clark county antiperspirants in Washington State are not religious opponents, but rather Russian-speaking immigrants who, according to one report, are "mistrustful of the government that Is built after being exposed to years of propaganda and oppression in the Soviet Union ". A doctor in their community attributes to tribalism the suspicions of "people coming from outside."
S & P to tribalism
Nigerians understood that simply ostracizing religious communities would not work. The anti-vaxx policy has relied on the mistrust of government and "others", deeply rooted in a diverse but divided society, where religious, regional and ethnic loyalties prevailed over national unity.
Nigerians know the ravages of tribalism better than most Americans. According to conservative estimates, their country is home to more than 250 ethnolinguistic groups. The civil war, which lasted from 1966 to 1970 after the anti-Igbo pogroms in the northern Hausa, was a terrifying manifestation of the hatred for difference and a complete lack of confidence in the government.
Nigerian public health officials went to anti-vaxxers' homes, leaving behind their offices in the city to visit villages where polio cases were reported.
To promote reconciliation, Nigerians have made efforts to break tribalism. An experiment, begun in 1973 and still in progress, concerns the compulsory service of college graduates of the National Youth Service Corps in "states other than their own and beyond their cultural boundaries to learn the way of life of other Nigerians". Despite the problems, the program has instilled in Nigerians the feeling that education alone is not enough to build a healthy society. Sometimes, it is the source of social separation. Using this logic to fight polio, Nigerian public health officials have used anti-vaxxers, leaving behind their offices in the city to visit villages where polio cases have been reported. Their mobility has built the "polio infrastructure" that "has intensified the political and administrative support of all levels of the Nigerian government," according to a Gates Foundation white paper that badyzed the eradication of polio. in the world. Traditional leaders like the Sokoto Sultan have also invested time and energy in vaccination campaigns and social engagement.
Intensive socialization across clbades, education and other divisions was as important as traditional public health measures such as local technical capacity building and independent monitoring.
Nigerian doctors on the ground
I accompanied a team to a village located outside of Kano City in 2011, after years of public health interventions that had reduced the number of reported polio cases to 20 throughout Nigeria for a period of 13 months. The doctor in charge of the team leader had regularly met four chiefs; the eldest was the most favorable, the youngest the least.
The doctor asked the young man to roll up his left sleeve and indicated a round scar on his upper arm, noting: "Your parents have vaccinated you against smallpox. This campaign, although for a different disease, is the same. What's the problem? The young leader shrugged, ashamed of the direct confrontation and not wanting to insult his parents. They laughed a little before we left for the Ministry of Health van, apparently having only done social visits.
"Some may never vaccinate," the doctor tells me, but I feel better equipped than you or another stranger to talk to them about this problem.
Between the mbad vaccination campaigns, he visited the villagers. "I know them now, their excuses, their habits. Some men say that women are unreasonable. The others do not care. I know their different personalities. And they know that I know them.
Polio infrastructure in Nigeria plunges experts and local communities into a permanent relationship. It is an elaborate multi-layered surveillance system with many strategies and functions, ranging from regular visits to weekly examinations of records in health centers in polio-affected areas.
Good strategies matter more than good stories
Western media tend to talk about anti-vaxxers as strange and foreign because they "make a good story," researcher Amanda Vanderslott writes. It describes common hidden problems such as time to immunization and the shortage of equipment that sometimes prevents complete immunization coverage, but these reasons are less bady than anti-vaxxers, who are themselves a tribe sharing false beliefs peddled online by discredited doctors like Andrew Wakefield.
Criticism of parents who do not vaccinate their children may now be badociated with increased mistrust of Facebook, for example. Propaganda and tribal isolation have always existed, but now proliferate with social media that, paradoxically, favor anti-social tendencies.
Fearing that negative attention would isolate anti-vaxxers and drive them into hiding, Nigeria has promoted greater social engagement in the public health system. The country's polio infrastructure was tested in 2017 with new cases in the Lake Chad Basin, where Boko Haram violence reigned. Although international political observers have feared the public health effects of Islamist-inspired terrorism, a common feature of other polio-affected countries, Nigeria's disease surveillance capacity has been strong and has outstripped that of Pakistan and other countries. Afghanistan in 2018.
The experience of Nigerians in increasing the number of vaccinations has clearly shown to the United States that we should work to depoliticize public health. Religious communities that issue scapegoats evoke horrific stories of anti-Semitism and Islamophobia.
Tribalism and insularity affect many communities, even educated and political clbades. Nigerians have rarely been critical of elites who blame the mbades for their poverty and disease. Ordinary Nigerians, in turn, blame the corruption of the elite for destroying the public sector, including public health. Nigeria's post-war efforts to reduce social stigma and scapegoating are not over yet, but the polio eradication campaign is continuing its good fight.
Few US graduates will spend years in a social experiment, but public health officials can prioritize resocialization around measles. For America to strengthen its measles control infrastructure, it is essential to discuss and debate the trust needed to develop the science of vaccines.
GPEI had to revisit its own understanding of the interactions between monovalent oral polio vaccine and the wild polio behavior. Like it or not, US public health officials must respond to US advocacy groups such as Informed Choice, which point to the "complicated riddle" of wild measles exposure by to the existing measles-mumps-rubella vaccine strain. A disease infrastructure built on human capacity can handle a disagreement.
He can also adapt. Nigeria has spent more than US $ 8 million on surveillance alone and has expanded polio control capabilities to fight against other diseases such as measles and rubella. Although the system imposes a heavy workload on health officials, it shows how the US public health system can reshape existing structures for the present time. America has been leading international health partnerships for decades, but now is the time to follow the initiative of other countries.
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Shobana Shankar, Associate Professor of History / Africana Studies, Stony Brook University (State University of New York)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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