The CIA and polio in Pakistan: A hard truth

Today in Pakistan there’ll be a lot of attention given to the announcement in the US that the CIA has promised not to use vaccination programmes as cover for covert operations. That decision is of course a good thing. But in Pakistan the fake hepatitis campaign in Abbottabad has become a convenient excuse for the failure of its efforts to tackle polio.

I met lady health workers – as we must call them here – in Karachi recently who told me that the fake campaign is not generally the reason families refuse the oral polio drops. The number one concern is that the workers are using out-of-date vaccines and vitamin supplements, which they said had in fact been the case on at least two occasions. Then there is the long-standing conviction that the vaccines are part of a plot to make Muslims infertile. Then finally there is the problem that the workers have two days, plus an extra day of catch-up, to immunise hundreds of children in their patch – not enough to spend time on the doorstep explaining the merits of the programme and refuting spurious objections.

Of course, that is only Karachi. Maybe in the tribal areas or other parts of the north-west then Dr Shakeel Afridi’s fake campaign is more of a problem.

My suspicion is that it has become a convenient excuse. Take this from today’s Dawn:

PART of Pakistan’s polio problem may be that some in the official machinery seem to have fudged figures to make it appear as if large numbers of children had been vaccinated when this was in reality not the case. On Friday, the Senate was told the provinces had sent ‘fake’ reports related to the anti-polio drive. According to the minister of state for national health services, the provincial governments shared “fabricated” figures with the centre. At face value this claim seems to have substance, as if there had indeed been 80 or 90pc success in the immunisation campaign, Pakistan would not be leading the world in the number of polio cases reported so far this year. What is needed at all levels of the state machinery is honesty about what has gone wrong with the drive to eradicate polio from the country. A proper investigation is in order and the provincial health departments need to explain if figures indeed had been fabricated.

In a country that fails to deliver so many basic services, where corruption and mismanagement affect many spheres of public life, it seems wrong to focus on external disrupting factors. Unethical and wrongheaded though the CIA campaign may have been, it is not the sole cause of Pakistan’s problem with polio.


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