Health Debate: Prosecute Parents who Refuse to Vaccinate Children for Polio

The culture has changed and those who refuse to do the right thing and protect children should be punished accordingly. Soft power is no longer enough; the imperative to protect children calls for hard power and swift consequences.

All children have the right to life and health and this is a fundamental human right. Nigeria is party to the Convention of the Rights of the Child and as such the country has a legal document to back the prosecution of parents who refuse to vaccinate their children. I put it to you: a single unvaccinated and infected child could “excrete 3 million virus parts in faeces every day for at least 27 days.” These virus parts pose a major risk of polio infection to 200 more children. This sort of recklessness by some parents cannot be acceptable to the health system, which has a responsibility of protecting the health and wellbeing of Nigerian children.

Nigeria’s history with the polio virus is long and dramatic. Poliomyelitis, a debilitating disease that destroys the nerves and paralysis some of his victims has been a special scourge to Nigerian children. The history of polio in Nigeria provides snapshot of the failure of the Nigerian health system. Nigeria is one of the 4 countries where polio cases can still be found today, and the failure of the health system to properly vaccinate children has led to the reoccurrence of polio in 12 other African countries who have previously eradicated the disease. Polio in Nigeria is not only a Nigerian problem; it is a global health concern that the Nigerian government must pay attention to.

By the time Nigeria removed the last military dictator in 1999, the long neglect and corruption that characterized the health system had pushed the polio rate to 981. The main responsibility of the new government on health was vaccinating Nigerian children and preventing polio and so the struggle began. It started with a valid questioning by Northern parents. They wondered why the southern led federal government suddenly cared so much about their children’s health after decades of neglect. They also wondered why polio was so important, when diarrheal, malaria and cholera seemed to claim more young lives regularly and the drugs for those other diseases were not available or free. Polio was not a pressing problem as far as they were concerned. And then in July 2003, two powerful Muslim groups publicly questioned the safety of the polio vaccine, insinuated that the vaccines were being used to sterilize Northerners, and called for a mass boycott of the Vaccination exercise.  By 2006, there were 1,143 cases of polio reported in Nigeria, a increase from the 355 cases reported for 2003. Parents refused vaccination and sometimes pretended and lied to health workers that their children were already vaccinated. It was complete distrust between the community and the government’s health workers caused by historical precedence, ethno-religious suspicions, and power struggles.

Contrary to the usual response to public health difficulties in Nigeria, the government actually did something to change the hearts and minds of the people. High level meetings with powerful religious and ethnic leaders were held, state and local governments were empowered to do more, vaccines were bought from Indonesia, a Muslim country and the then governor of Kano state allowed the Southern President, Olusegun Obasanjo, to publicly vaccinate his child. A threat about Hajj was made as well; the faithful were told they would not be allowed into Mecca if they were not vaccinated, as Saudi Arabia required a valid polio vaccination card before entering the country. A year later, it seemed all the efforts to change the minds of the community had worked! The polio rate in 2007 was 353 and by 2010, the rate had fallen to 48 reported cases. It was a fantastic triumph of soft power wielded gracefully by the government, incredible administration of the vaccine system and finally public commitment by Northern leadership. It worked.

It would have been a great story if it had ended with incremental but decisive decrease over the years until zero cases were reported. But Boko Haram happened and now a community in Jigawa State, last month, refused to vaccinate their children. 45 rejections were recorded within a single Local Government Area at the same time, with the religious leader also joining the dissenters.

It seems that we are back to 2003 again and this calls for an innovative and decisive action from the leadership of the country before other communities catch on to the trend and polio becomes another public health epidemic. So I argue that all parents who refuse to vaccinate their children be faced with criminal charges of neglect and reckless endangerment of children.

The historical reasons for refusing polio vaccination are no longer widespread or valid in the North. The Sultan of Sokoto has publicly stated his support of vaccination and likewise many other prominent religious leaders. As such, those small numbers of parents who are refusing to vaccinate their children can be prosecuted without sparking a major public backlash. The culture has changed and those who refuse to do the right thing and protect children should be punished accordingly. Soft power is no longer enough; the imperative to protect children calls for hard power and swift consequences.