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The politics of the 1996 cerebrospinal meningitis epidemic in Nigeria

Published online by Cambridge University Press:  07 December 2011

Extract

The 1996 cerebrospinal meningitis epidemic in Nigeria exemplified a medical situation that was linked with political concerns at the local, national, and international levels. It is argued that these political aspects must be understood, as they have implications for the treatment of future outbreaks. This article examines local attempts to stem the epidemic, on the basis of participant observation and epidemiological data collected from the north of Kaduna State. The epidemic is then considered in the national context: general deterioration of the health care system associated with economic decline, a national structural adjustment programme and crisis of political leadership. The local and national contexts of the 1996 epidemic are related to the view, held by many Nigerians, that reports of the epidemic's severity and the subsequent Saudi ban on Nigerians making the pilgrimage to Mecca reflected international politics, particularly the uneasy relations between the Nigerian, Saudi Arabian, and US governments, as well as health concerns. The article concludes with some recommendations for a national policy and for community health initiatives that take the politics and economics of cerebrospinal meningitis immunisation and treatment into account.

Résumé

L'épidemie de méningite cérébrospinale survenue au Nigeria en 1996 a illustré une situation médicate liée a des problèmes politiques au niveau local, national et international. Certains affirment qu'il est essentiel de comprendre ces aspects car ils ont des implications pour la gestion d'éclosions futures. Cet article examine les tentatives locales d'enrayer l'épidémie sur la base des observations des participants et des données épidémiologiques recueillies dans l'etat de Kaduna, au nord du pays. L'épidémie est alors étudiée dans le contexte national: détérioration générale du système de santé associée au déclin de l'économie, à un programme national de restructuration et à une crise du pouvoir politique. Le contexte local et national de l'épidémie de 1996 est lié à l'opinion partagée par de nombreux Nigériens selon laquelle les informations diffuseées sur la gravité de l'épidémie et l'embargo imposé par la suite par l'Arabie Saoudite aux Nigériens désireux d'effectuer le pélerinage de La Mecque étaient le reflet de la politique internationale, et en particulier des rapports difficiles entre les gouvernements du Nigeria, de l'Arabie Saoudite et des États-Unis, ainsi que des problèmes de santé. L'article conclut en énonçant quelques recommandations pour une politique nationale et des initiatives nationales de santé communautaire prenant en compte l'aspect politique et économique de l'immunisation contre la méningite cérébrospinale et de son traitement.

Type
The politics of a modern epidemic
Information
Africa , Volume 68 , Issue 1 , January 1998 , pp. 118 - 134
Copyright
Copyright © International African Institute 1998

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