With the opening of “Zero Dark Thirty” this week, many have condemned the depiction of torture in the film — and debates have resurfaced about the “enhanced interrogation” of suspected terrorists by the United States to find Osama bin Laden. What gets left out of these discussions is the role that a deplorable espionage tactic played in the manhunt and the wide-reaching effects that this tactic has had in global health.
I’m talking about the use of a fake vaccination program in Pakistan, run by the C.I.A., that drew blood samples from children in Abbottabad to check their DNA against relatives of bin Laden’s, a story I covered more than a year ago and again this July when the Taliban banned polio vaccinators from operating in Northern Pakistan. Now, nine health workers who were administering polio vaccines have been killed across Pakistan. These coordinated attacks have forced the WHO to suspend a major vaccination drive in the country.
Pakistan is one of three countries in which polio is still endemic (the other two are Afghanistan and Nigeria), although there were resurgences found in Angola, Chad, and the DRC this year. In one of the greatest public health near-victories of the past century, we’ve almost eradicated this devastating disease, reducing cases by 99 percent in 25 years. You rarely see numbers like that in global health efforts — smallpox is the only disease affecting humans that we’ve managed to eradicate. We’ve made these incredible gains through preventative measures: by vaccinating 2 billion children in the past quarter-century.
When news about the fake vaccine program (which was for hepatitis B, not polio) surfaced, I wrote that it was an unacceptable ruse that undermined global health efforts and took away the ability to trust doctors. As I wrote in July, polio vaccinations are a particularly fraught issue in some parts of the Muslim world, where the drives are seen as a Western conspiracy to infect Muslim children with HIV or conduct espionage, which is why objections to polio programs grew instead of objections to hepatitis prevention. The New Yorker pointed out that in 2004, we nearly wiped out polio, but condemnations from mullahs in northern Nigeria about the programs meant that people refused vaccinations, contracted the disease, and traveled to Mecca for the hajj, where they spread polio to other pilgrims.
According to the AP, the Pakistani Taliban — the prime suspect in the attacks — have distanced themselves from the killings, and there is no confirmation of who organized the two-man motorcycle teams who shot and killed five female health workers on December 17 within the span of an hour, adding four more victims in the following days, some of whom were teenagers. It’s probable that the C.I.A. program is not directly responsible for these deaths, since there are a number of other cultural factors, such as suspicion of polio programs in general, as well as the liberation of women, that could have added motivation for the violence. At the same time, it added fuel to a very volatile fire. As Michael Specter wrote in the New Yorker last week, “There is a history here, and somebody in the American intelligence community should have known it.” Unfortunately, that ignorance, or willful disregard, has potentially contributed to the deaths of nine people and put the great progress we have made against polio in serious jeopardy.