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PARALLEL DILEMMAS: POLIO TRANSMISSION AND POLITICAL VIOLENCE IN NORTHERN NIGERIA

Abstract
ABSTRACT

Nigeria is one of three countries where polio continues to be endemic. In northern Nigeria, areas with low levels of polio immunization due to persistent parental opposition as well as implementation and infrastructural problems have contributed to wild poliovirus transmission. Furthermore, political violence associated with Islamic groups opposed to the federal government has also hampered the conclusion of the Global Polio Eradication Initiative (GPEI) efforts. This violence, which began in Borno State and has spread to other parts of northern Nigeria, occurs precisely where poliovirus transmission continues. These two related aspects – parallel dilemmas of low immunization and political violence – confound the conclusion of GPEI efforts in Nigeria. This situation also raises ethical questions both about the final stages of eradication efforts and about military actions to contain ongoing violence. The Nigerian government's attempts to suppress opposition to the polio eradication campaign by threatening non-compliant parents with arrest and by closing down media outlets may frighten some parents into compliance but can also breed resentment and resistance, just as military and police activities, such as house-to-house sweeps and widespread arrests, may encourage sympathy for Islamic insurgents. This situation suggests that the possible solution of one problem – the ending of wild poliovirus transmission – depends upon a solution of the other, i.e. the cessation of violent anti-government activities.

RÉSUMÉ

Le Nigeria est l'un des trois pays dans lesquels la poliomyélite reste endémique. Dans certaines régions du nord du Nigeria, la faiblesse du taux d'immunisation contre la poliomyélite, résultant d'une opposition parentale persistante ainsi que de problèmes de mise en œuvre et d'infrastructure, a contribué à une transmission du poliovirus sauvage. De plus, la violence politique associée aux groupes islamiques opposés au gouvernement fédéral a également entravé la conclusion des efforts de l'Initiative mondiale pour l’éradication de la poliomyélite (IMEP). Cette violence, qui a débuté dans l’État de Borno avant de gagner d'autres parties du nord du Nigeria, survient précisément là où la transmission du poliovirus persiste. Ces deux aspects liés, dilemmes parallèles de faible immunisation et de violence politique, empêchent l'IMEP de mener à bien ses efforts au Nigeria. Cette situation soulève également des questions éthiques sur les dernières étapes des efforts d’éradication, mais aussi sur les actions militaires engagées pour contenir la violence persistante. Les tentatives du gouvernement nigérian de réprimer l'opposition à la campagne d’éradication de la poliomyélite en menaçant d'arrêter les parents réfractaires et en fermant des organes de presse peuvent amener certains parents à se soumettre par la peur, mais aussi engendrer du ressentiment et de la résistance, tout comme les activités de l'armée et de la police, telles que fouilles maison par maison et arrestations massives, peuvent inciter à la sympathie pour les insurgés islamiques. Cette situation suggère que la solution possible d'un problème, à savoir mettre un terme à la transmission du poliovirus, dépend d'une solution de l'autre, à savoir la cessation des activités violentes contre le gouvernement.

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