To what extent are polio vaccination programmes in Pakistan being manipulated by the Taliban?
5/07/2012 - The resurgence of polio poses a serious international threat, particularly to countries with weak medical infrastructures, which is why recent news that polio vaccination programmes are not reaching enough children in Afghanistan and Pakistan is of particular concern. In 2011 there were 198 cases in Pakistan and 80 cases in Afghanistan, compared with 40 cases in Pakistan and 31 in Afghanistan in 2006. According to researchers at Imperial College London and the World Health Organisation (WHO), “Sharp declines in vaccine uptake led to a rise in the number of new infections between 2006 and 2011, even though new vaccines introduced during this time have proven to be more effective against the main circulating strain of the virus.”
Both Afghanistan and Pakistan will this year implement national emergency action plans in attempts to deal with the escalating number of cases, but as they do so it appears that very few people in the global media are asking why these vaccination programmes have declined in strength.
Earlier this year, the WHO removed India from its list of polio-endemic countries and the South Asian country has not had a recorded case of polio in more than a year. Today however, journalists at the Times of India published concerns that the polio virus may be re-entering the country by way of Pakistan and Afghanistan as a direct result of the fact that, as they put it, “A major chunk of children below three years in Pakistan and Afghanistan are not receiving the all-important oral polio vaccine.”
An article in the New Scientist recently suggested that the Taliban have deliberately reduced access to polio vaccines in Pakistan in order to acquire political leverage over the US’s decision to continue with drone strikes against suspected terrorists in the region. “If anything qualifies as a threat worth watching”, writes Debora MacKenzie in New Scientist Threatwatch, “ it is the resurgence of polio, one of the most feared diseases of the twentieth century [...]The long campaign to eradicate polio was threatened this week by the actions of Hafiz Gul Bahadur, a Taliban commander in the North Waziristan region of Pakistan. Bahadur banned a campaign to vaccinate 161,000 children against polio, until the US calls off drone strikes against suspected terrorists in the region.”
The situation in Afghanistan is less clear, but this recent ban on vaccinations by a senior figure within the Taliban may be indicative of a wider effort to use polio as a bargaining tool. Not only might the Taliban put their own national citizens at risk but also the wider international community, which will no doubt put increased pressure on international health organisations to intervene and insure access to vaccinations before the disease becomes more prevalent and counter-productive to more succesfull vaccination programmes elsewhere.
The eradication of polio is within close grasp of international health authorities, who have implemented difficult and expensive plans to eradicate it. “What will be easier?”, asks MacKenzie: “Convincing a Taliban commander that using a virus as a bargaining chip just shoots his people in the foot? Or convincing panicking world finance ministers not to abandon a disease eradication drive that is within the last agonising inch of victory?”
Perhaps we might also ask, at what point does the manipulation of vaccination programmes become attractive to other militant groups seeking similar control over foreign interventions to their national politics? Polio is showing signs of resurgence in Nigeria, the seventh most populous country in the world, where militant activity is prolific. The onus is on health authorities to engage in talks with these groups to explain the effectiveness of vaccination programmes and the futility of their interruption – for the benefit of all.
1. KM O'Reilly et al. 'The effect of mass immunisation campaigns and new oral poliovirus vaccines on the incidence of poliomyelitis in Pakistan and Afghanistan, 2001-11: a retrospective analysis.' The Lancet, 4 July 2012. \">http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60648-5/abstract