Vaccines and immunization: The past, present and future in Nigeria

Abstract

Smallpox eradication was a result of leadership provided by the World Health Organization headquarters and regional offices, national governments and, not least, national and multilateral aid agencies. The involvement of all these agencies encouraged a series of immunization initiatives and give rise to ambitious new goals for the eradication of diseases. The National Immunization Programs in Brazil and other countries, the WHO Expanded Programme on Immunization and the goal of global polio eradication were some of the more immediate results of successful smallpox eradication. Advances can be acknowledged ; yet, several goals remain unfulfilled. The politics of global health, as well as the design and deployment immunization policies, have become increasingly complex in their various dimensions. This is unsur-prising in a situation where immunization projects have been are populated by new actors, new goals and new vaccines. The past, present and future of these trends are put under scrutiny by a range of historians in this issue of Ciência &Saúde Coletiva. Immunization, in the form of an idealized dream, is a dream come true-a miraculous technological product, in the form of painless and a safe vaccine, ensures that many generations of society are protected from dangerous diseases. Reality, however, is far more complex. Technological products are not always as efficacious as advertised by manufacturers and other advocates. It is also worth noting that there are-and always have been-differing notions about vaccinal safety and effectiveness at any point of time. That some voices are heard-and advertised-more loudly than others is part of a complicated process of political and social negotiation; a point that is ignored or downplayed by those seeking to promote the idea of supposedly value free nature of science. Public health, medicine and all the sciences that underpin them are anything but; conceptions about disease, cures for it and even efforts to advocate the primacy of certain interventions over the others are deeply influenced by a variety of social, political and economic considerations (which are often shifting in nature). Global funding agencies are often swayed by those who insist that ever more effective "magic bullets" can be developed and put into place seamlessly; that should not be reason enough for us to agree with such a view and ignore the social negotiations that are capable of rallying stakeholders for interventions, the effective dissemination of information and the responsible development of ethical norms for field practice. Meaningful policy can only be developed on the back of meaningful commitment to the democratic introduction of health regimes. Democracy involves listening to other, often contrasting viewpoints, no matter the economic or social standing of those making the arguments. Such sensitivity in public health is time-consuming, but this type of investment of effort is always worthwhile, not least as it increases the quality of local stake-holding and also brings in a crucial el...

A review of neonatal tetanus in University of Maiduguri Teaching Hospital, North-eastern Nigeria

“…In addition, harmful traditional practices towards cord care such as hot fomentation, application of charcoal, etc., would have also contributed. Other studies have reported similar effects of these factors on neonatal tetanus 91014…”

Neonatal Tetanus and Gender Disparity

“…Although efforts put in place by international agencies and government of countries towards improving the health of children across the globe has yielded positive results, arguably this is more in the developed countries than the developing countries. With an estimated 10 million annual deaths of children under the age of 5 years across the globe, it is sad to note that 4 million of these deaths occur within the first 28 days of life of these children, and in the developing countries 1,2,3,16,17,18 . Thus, the burden is more on the developing countries due to the enormous challenges with high infant and neonatal death rates.…”

“…Studies show that Neonatal tetanus (NNT) is still one of the most underreported deadly vaccine preventable diseases that is commonly seen in the developing countries. In spite the increased commitment from governments of countries that have NNT, it is estimated that only 5% of cases reports to the heath services especially within the under-developed countries 4,5,6,16,17,18 .…”

“…As a result of this unacceptable high neonatal mortality rates, during the World Health Assembly of 1989 and the World Summit for Children in 1990, that the WHO, UNICEF and other partner agencies developed a strategic NNT elimination framework with the initial target date in 1995 4,5,16,17,18 . The NNT elimination framework targets less than 1 NNT case per 1,000 live births per annum in every district of every country across the globe.…”

Introduction of Inactivated Polio Vaccine and Specific Determinants of Vaccine Hesitancy

“…Haemophilus Influenzae Type B vaccine (Hib) was introduced into the Nigerian national immunization programme, 33 years after Hib vaccine introduction [1] [2]. Similarly, other vaccines such as polyvalent pneumococcal conjugated vaccine (PCV) and Rotavirus vaccine (RV) have been introduced in many countries [3] [4]. These vaccines have not been included in the publicly funded National Immunization Programme in Nigeria, so parents/caregivers who want their children to receive the vaccines have to pay out-of pocket.…”