Since the middle of December, at least twenty-five people taking part in polio eradication campaigns have been murdered by Islamist insurgents in Pakistan and Nigeria. A few of these were foreign aid workers, but most of them were local health workers and volunteers. During the same period only two new cases of the disease itself have been reported worldwide. So what does this mean for the final stages of the thirty- year old campaign to eradicate polio?
The recent assassinations of polio immunisers
On December 18 four women and one man were attacked by gunmen in three separate incidents in Karachi, Pakistan's largest city, and a woman was killed in the north-western city of Peshawar. Peshawar lies close to the tribal areas, and is a haven for the Taliban and other militants who ordered a ban on polio vaccinations in June.
On January 1 in Pakistan's Khyber Pakhtunkhwa province (the same conservative province where last October militants seriously wounded 15-year-old Malala Yousufzai, the outspoken young activist for girls’ education) gunmen on motorcycles sprayed a van carrying employees from a community centre with bullets, killing six women and one man. The victims were killed on their way home from a community centre where they were had been vaccinating children at a medical clinic and primary school. Their driver was injured but a young child was removed from the van by the assassins before they gunned the rest of the occupants down.
This month at least twelve women who were taking part in a polio vaccination drive have been shot and killed in northern Nigeria, where women volunteers often go from house to house to carry out the vaccinations as Muslim families feel more comfortable allowing women inside their homes than men. It also signalled a new wave of anger targeting immunisation drives in Nigeria, where clerics once claimed the vaccines were part of a Western plot to sterilize young girls.
The first attack saw gunmen arrive by three-wheel taxis and open fire. At least eight female vaccinators died in that attack, witnesses said. The second attack, saw another four people killed. The witnesses spoke on condition of anonymity out of fear of angering the radical sect known as Boko Haram. Boko Haram, whose name means "Western education is sacrilege" in the Hausa language, has been behind a series of violent attacks across northern Nigeria as part of its fight against the country's weak central government. It is blamed for killing at least 792 people last year, including a single attack in Kano last January that killed at least 185.
Suspicion of Western motives
Some communities have long-held beliefs that the motives of the polio vaccinators are not benign. In South Asia and sub-Saharan Africa militants have been spreading paranoid conspiracy theories about vaccines for years. Parents and families have been told that they are pointless, poisonous, covert shields for nefarious government agendas meant to do children harm. In 2003, a group of imams in the Nigerian state of Kano began preaching against polio vaccination, contending that what purported to be a protective act was actually a covert campaign by Western powers to sterilize and kill Muslim children. The president of Nigeria’s Supreme Council for Sharia Law told the BBC: “There were strong reasons to believe that the polio immunisation vaccine was contaminated with anti-fertility drugs,...certain virus that cause HIV/AIDS, ....with Simian virus that are likely to cause cancers.”
The Hunt for bin Laden and the covert operators who posed as vaccinators
Such accusations undoubtedly caused years of delay to polio eradication, but by the end of 2010 the End polio Now Campaign truly felt that it had succeeded in winning over hearts and minds in the last three countries where polio was still endemic - Nigeria, Pakistan and Afghanistan. Then in 2011, according to The Guardian and The New York Times the CIA decided to use a fake vaccination program for Hepatitis B in the hunt for Osama bin Laden. The CIA needed to prove that the family in the compound in Abbottobad were the bin Ladens, and the idea was that a local doctor would somehow obtain DNA samples from children in the compound while they were being vaccinated, and these samples could then be compared with the DNA of Bin Laden's sister, who died in America in 2010.
There is no evidence the “vaccinations” produced DNA that helped identify bin Laden. The physician named in the article has been arrested by the Pakistani security forces, and the CIA has understandably refused any comment. But the allegation that a vaccine program was not what it seemed — that it was not only suspect, but justifiably suspect — has been very widely reported.
This is truly awful. The use of a vaccination campaign as part of a covert espionage operation, and the subsequent discovery of the fact that a campaign has been used in this way has played into to the hands of the most paranoid believers in conspiracy theories.
Thirty years ago, when End polio Now began, there were over 350,000 new cases every year in over twenty countries, this declined to 222 cases in five countries last year. A decade ago, Nigeria was forced to suspend polio vaccination for almost a year because of these paranoid rumours. This sparked an explosion of polio cases, not just in Nigeria, but in 20 other countries that previously had been declared polio-free. Let us hope that this doesn't happen again.