ISLAMABAD, Pakistan — Pakistan has been engaged in a full-scale war against polio since eradication efforts started in 1993. However, recently, a new player joined the game, the CIA. For years, the CIA undercover fake vaccine operations put a strain on the eradication efforts, until recent news from the White House indicates such operations have stopped.
Polio is not a concern in most places. The number of cases worldwide has dropped from 350,000 in 1998 to 416 in 2013. However, polio has never been successfully eradicated in Pakistan. The country remains one of three nations, along with Afghanistan and Nigeria, where the disease occurs and spreads naturally. Of these nations, Pakistan experiences the most cases.
So far in 2014, there have been 77 cases worldwide, 61 of which occurred in Pakistan. According to the World Health Organization (WHO,) one of every 200 of these cases leads to paralysis and a small fraction result in death, and for every case, there are 200 people carrying the disease.
While polio has an effective vaccine that has made eradication possible, it is difficult to distribute vaccines in politically unstable or poverty-stricken areas. In addition, the presence of insurgents often hinders efforts to vaccinate children under 5, the target demographic for the disease. But it is rumors that are the most effective in stunting vaccination efforts. Such rumors started 10 years ago in Nigeria, when local religious leaders claimed the polio vaccine was a Western plot to sterilize their girls, and since then, this idea and other gossip has spread to more regions where polio is endemic.
New rumors emerged in July of 2011, when The Guardian published a piece on the underground CIA vaccination operations. These operations were confirmed by then director of the CIA, Leon Panetta, in January of the following year.
The CIA employed Pakistani doctor Shakil Afridi to run a fake hepatitis B vaccination campaign which enabled the CIA to collect DNA and information in the compound where they suspected Osama bin Laden was hiding. The goal was to collect samples using residual blood obtained during a vaccination to compare the DNA to bin Laden’s deceased sister’s. This would prove that bin Laden’s children were living in the compound, thus increasing the likelihood that bin Laden himself was in the neighborhood. The vaccination operation ultimately failed to prove anything and Afridi was imprisoned for treason in May of 2012.
The CIA operation in question administered hepatitis B vaccinations, which are given by a shot. Even though polio vaccines are distinguishable because they are given orally, the stigma against polio aid workers was already in place, and the CIA’s operation caused backlash against all vaccinators and proved to be a significant setback in the eradication of polio.
The violation of trust caused by the CIA has endangered public health efforts and those working in the field. Rising distrust has sparked violence against legitimate vaccination workers. After nine public health workers were killed in December 2012, the United Nations withdrew its vaccination teams. Since then, over 60 polio vaccinators have been killed in Pakistan alone.
In addition, after the fake vaccination operations were uncovered, Taliban commanders banned polio vaccines in North and South Waziristan regions back in 2012. The ban is still in place today, and the majority of cases of polio in Pakistan come from the Waziristan region.
Ultimately, the CIA’s operations worsened conditions for the fight against polio. It is predicted that the fake campaign could postpone eradication in Pakistan for another 20 years, leading to 100,000 more cases that could have been prevented. Polio has been spreading since the Taliban stopped vaccination efforts, and the country now sees a spike in cases. Pakistan reported 83 new cases of polio in 2013 alone.
On top of this, the WHO declared polio a global health emergency on May 5. Polio has recently begun spreading from the three countries where it is endemic. In 2012, it existed only in Pakistan, Afghanistan and Nigeria, but new cases have since been found in Syria, Iraq, Cameroon, Guinea, Kenya, Ethiopia and Somalia. The U.N. is recommending that Pakistan, Cameroon and Syria vaccinate all citizens before they leave the country, and the WHO is echoing the call for international travel restrictions coming from these countries. It has become apparent that any hindering of vaccination efforts will cause a global calamity.
However, there is good news. In the face of this increase of polio, the White House has announced that the CIA will no longer use vaccination efforts in its information harvesting efforts. This information comes in response to a letter from the deans of 12 U.S. public health schools that was sent to U.S. President Barack Obama in January 2013, arguing that these operations are harming public health efforts and the “collateral damage” was too much. The White House responded in May, stating that operations of this type had stopped in August of 2013.
The public announcement of the change in CIA operations will hopefully keep public health workers safer as they continue to vaccinate for polio. In addition, this knowledge will hopefully encourage Taliban commanders to lift the bans on vaccines, thus decreasing the number of cases of polio coming out of their regions. With any luck, the vaccination teams will be able to return to vaccinating as many children as possible in Pakistan and the disease will cease to be so prevalent in the country and around the world.