Journalist and Author
Image: Julian Harneis (CC), Flickr
There’s news out this week that feels almost impossible to deliver without an eyeroll: The CIA has promised that it will “never again” use an international vaccination campaign as a cover for intelligence gathering.
I can’t see why not. I mean, the last attempt ended so well.
(Yes, that was sarcasm.)
Image: André Luiz D. Takahashi (CC), Flickr
In a move that is simultaneously discouraging, urgent and deeply unusual, the World Health Organization has declared that the resurgence of polio is a “public health emergency of international concern.” It’s an extraordinary statement, coming less than four months after India — once considered a place where polio might never be vanquished — was declared polio-free after three years without a new case.
That achievement left only Afghanistan, Nigeria and Pakistan as countries where the chain of polio transmission had never been broken. But as the virus persists in those countries, it is also moving out across their borders. Seven other nations that previously had beaten polio — Cameroon, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Syria — have now been reinfected, and the virus is spreading in communities there.
If the continued existence of polio is news to you, you’re not alone. It’s a largely forgotten disease in the industrialized West; the last United States case occurred in 1979. The WHO, the Centers for Disease Control and Prevention, the fraternal organization Rotary International and a raft of partners have been pressing an international and very expensive eradication campaign since 1988. Every time the world has gotten close, though, polio has flared up again. The WHO once thought it would be able to declare the disease eradicated in 2000; then it set 2005 as a target; then 2008; 2012; 2015; and now, a hoped-for 2018. (Here’s my archive of posts.)
But the past couple of months have thrown even that into doubt. The trigger for the WHO’s action was the discovery that there have been 74 cases of polio so far this year. That seems like a low number, but there were only 417 in all of 2013. And, crucially, winter is considered polio’s “low season” — so for polio to be spreading now rings an alarm bell for the warmer, wetter months when it usually spreads faster and further.
When last we left the long asymptote of polio eradication, nine health workers in Pakistan who had been administering polio vaccine had been murdered, presumably by the Taliban or its sympathizers, because polio eradication has been cast by them as a plot against Islam in the wake of a CIA operation which used vaccinations as an attempt to get close to Osama bin Laden.
(If this story is new to you: Yes, really. For background, start with this post, and then read this, this, and this.)
So it’s discouraging to say that, in the past few weeks, the news hasn’t gotten any better — though some additional voices have joined the debate in an attempt to stress to the world how important this moment is.
There is news today, confirmed by several media outlets and also by the World Health Organization and UNICEF, that six people working as polio vaccinators were murdered in three separate coordinated attacks in Pakistan. While no one has yet claimed responsibility, it is widely assumed that the attackers have ties to the Taliban, which has opposed the polio-vaccination campaign as a Western plot and accused vaccinators of working as spies for the CIA.
This is grievous and appalling. Infuriatingly, it was also predictable. Constant readers will remember that, back in 2011, the CIA did use a vaccination campaign as a ruse to attempt to to find Osama bin Laden. The unsuccessful attempt was denounced all over the world for putting the polio campaign at risk, and news sources within Pakistan quickly began reporting that vaccinators were feeling threatened. Adding to the sense of threat, a Taliban commander blocked the campaign in one province last June, a United Nations doctor and his driver were fired on in July, and a vaccinator was executed in October by a man who roared up on a motorbike and dashed away.
Regular readers will remember my outraged rant post from almost a year ago, reacting to the news that the Central Intelligence Agency faked a vaccination campaign in Pakistan as a way of getting close to Osama Bin Laden’s hide-out, hoping to prove his presence by using a vaccine needle to grab a sample of DNA.
I felt, and still feel, that the maneuver — which was belatedly acknowledged by the CIA — was a cynical attempt to hijack the credibility that public health workers have built up over decades with local populations. I especially felt it endangered the status of the fraught polio-eradication campaign, which over the past decade has been challenged in majority-Muslim areas in Africa and South Asia over beliefs that polio vaccination is actually a covert campaign to harm Muslim children — an accusation that seems fantastic, but begins to make sense when you realize some of those areas have perfectly good reasons to distrust vaccination campaigns.
I take no pleasure in saying the prediction came true. [Read more…]
A number of years ago, I was in New Delhi, at the end of an exhausting 18 hours in which I had torn around the city to watch a National Immunization Day. On those days — like a national holiday, with flags and banners and kids let out from school — tens of millions of children line up to stick out their tongues and receive the sugary drops that contain the vaccine that should protect them against polio.
The Indian government, along with the Centers for Disease Control, the World Health Organization and the volunteer ground troops of Rotary International, has been organizing these days now for most of two decades, always coming closer to the goal of eradicating polio, never quite getting there. On this day, which occurred close to the end of weeks I had spent embedded with a WHO “STOP Polio” team, 135 million children were expected to queue in cities and suburbs and rich neighborhoods and slums. I spent the day with the team I had been observing, racing in a battered turquoise Tata from neighborhood to neighborhood, trying to understand where the campaign’s message was working and where its earnest persuasions had failed. (You can read my account of the day here.)
