Mil­i­tant Is­lamism and vac­cine skep­ti­cism

“The im­por­tance of lo­cal pol­i­tics – rather than reli­gious ide­ol­ogy – can be seen in the re­sponse to po­lio vac­ci­na­tion pro­grammes”

Financial Mirror (Cyprus) - - FRONT PAGE -

We know how to erad­i­cate po­lio. Since the 1980s, an in­ter­na­tional vac­ci­na­tion ef­fort led by the World Health Or­gan­i­sa­tion has driven the virus to the cusp of extinction. A dis­ease that killed or paral­ysed a half-mil­lion peo­ple an­nu­ally now in­fects only a few hun­dred.

What is stand­ing in the way of the virus’s erad­i­ca­tion is not med­i­cal or tech­ni­cal con­straints, but po­lit­i­cal re­sis­tance to the vac­ci­na­tion ef­fort. In­deed, the few ar­eas where the virus con­tin­ues to hold out share wor­ry­ing sim­i­lar­i­ties. Since 2012, 95% of po­lio cases have oc­curred in five coun­tries – Afghanistan, Pak­istan, Nige­ria, So­ma­lia, and Syria – all of which are af­fected by Is­lamist in­sur­gen­cies. In or­der to erad­i­cate po­lio, we must un­der­stand this link­age.

Is­lamist op­po­si­tion to vac­ci­na­tion pro­grammes is of­ten at­trib­uted to the be­lief that vac­cines are a Western con­spir­acy to harm Mus­lims, and that the vac­cines ster­ilise chil­dren, are in­fected with HIV, or con­tain pork. But it is im­por­tant to note that ji­hadists in Syria and Afghanistan have been largely sup­port­ive of po­lio vac­ci­na­tion cam­paigns. If the virus is to be de­feated, we will have to move be­yond car­i­ca­tures of Is­lamists as vi­o­lent zealots op­posed to Western sci­ence and look closely at the spe­cific po­lit­i­cal con­texts in which the erad­i­ca­tion ef­fort has so far been un­suc­cess­ful.

In Nige­ria, for ex­am­ple, the ex­trem­ist group Boko Haram’s an­i­mos­ity to­ward vac­ci­na­tion cam­paigns stems from an in­tra-Mus­lim con­flict rooted in the colo­nial era, when the United King­dom ruled north­ern Nige­ria in­di­rectly through a pro-Bri­tish in­dige­nous elite. The de­scen­dants of the colo­nial elite con­tinue to dom­i­nate the re­gion’s state gov­ern­ments, which are re­spon­si­ble for im­ple­ment­ing the vac­ci­na­tion pro­grammes. Boko Haram’s op­po­si­tion to the ef­fort re­flects its broader an­tipa­thy to what it re­gards as a cor­rupt and Western­ised po­lit­i­cal class.

Sim­i­larly, in south­ern So­ma­lia, at­tempts by out­siders to im­pose a sta­ble cen­tralised gov­ern­ment have gen­er­ated re­sent­ment to­ward po­lio vac­ci­na­tion pro­grams. Since the early 1990s, in­ter­ven­tions by the United Na­tions and the African Union in So­ma­lia have in­cluded troops from the United States and from the coun­try’s pre­dom­i­nantly Chris­tian neigh­bours, Kenya and Ethiopia. This has re­sulted in wide­spread dis­con­tent and has fu­eled sup­port for Is­lamist mil­i­tants, whom many So­ma­lis view as the main bul­wark against for­eign in­ter­fer­ence. In re­cent years, al-Shabaab mil­i­tants have at­tacked aid work­ers, mak­ing it very dif­fi­cult to un­der­take pub­lic-health pro­grammes in in­sur­gent­con­trolled ar­eas. Médecins Sans Fron­tières, for ex­am­ple, had to close its So­mali pro­grammes in 2013.

In Pak­istan, op­po­si­tion to the vac­ci­na­tion ef­fort has its roots in Pash­tun com­mu­ni­ties’ re­sis­tance to the na­tional gov­ern­ment. Broadly speak­ing, the Pak­istani Tal­iban is a Pash­tun move­ment, con­cen­trated in the semi-au­ton­o­mous Fed­er­ally Ad­min­is­tered Tribal Ar­eas in the north­west of the coun­try. This moun­tain­ous re­gion was never ruled di­rectly by the Bri­tish, and the Pash­tun have fiercely re­sisted at­tempts by the Pak­istani state to ex­pand its power. Thus, ex­ter­nal in­ter­ven­tions like the vac­ci­na­tion pro­gram are viewed as a stalk­ing horse for deeper gov­ern­ment en­croach­ment into Pash­tun ar­eas.

The Pak­istani Tal­iban’s hos­til­ity has been fur­ther hard­ened by US in­ter­ven­tions in the coun­try, in­clud­ing the use of a fake hep­ati­tis vac­ci­na­tion cam­paign to gather DNA from Osama bin Laden’s rel­a­tives prior to his as­sas­si­na­tion. For Is­lamist mil­i­tants, this con­firmed that po­lio im­mu­ni­sa­tion ef­forts are a cover for gath­er­ing in­tel­li­gence to iden­tify tar­gets for drone at­tacks.

The im­por­tance of lo­cal pol­i­tics – rather than reli­gious ide­ol­ogy – can be seen in the re­sponse to po­lio vac­ci­na­tion pro­grammes on the other side of the Du­rand Line. In Afghanistan, the Tal­iban is also a largely Pash­tun move­ment, but its at­ti­tude to­ward the po­lio erad­i­ca­tion ef­fort could not be more dif­fer­ent. When the Tal­iban ruled Afghanistan, from 1996 to 2001, it sup­ported the vac­ci­na­tion ef­fort, and in­deed it con­tin­ues to do so; a re­cent Tal­iban state­ment urged its Mu­ja­hedeen to pro­vide po­lio work­ers with “all nec­es­sary sup­port.”

This dif­fer­ence re­flects the po­lit­i­cal po­si­tion of Pash­tuns in the two coun­tries. In Afghanistan, Pash­tun are the ma­jor­ity; as a re­sult, they have a much stronger in­flu­ence in na­tional pol­i­tics than their coun­ter­parts in Pak­istan – and thus view the state with less sus­pi­cion.

In Syria, the big­gest ob­sta­cle to the vac­ci­na­tion ef­fort has been the cen­tral gov­ern­ment. The re­fusal of Pres­i­dent Bashar al-As­sad’s regime to al­low WHO to carry out vac­ci­na­tion pro­grammes in in­sur­gent-con­trolled ar­eas di­rectly re­sulted in a po­lio out­break in 2013. Mod­er­ate op­po­si­tion groups like the Free Syr­ian Army, with the help of the Turk­ish author­i­ties and lo­cal non-gov­ern­men­tal or­gan­i­sa­tions, have or­ga­nizsed their own vac­ci­na­tion pro­gramme in ar­eas out­side Syr­ian gov­ern­ment con­trol. Is­lamist mil­i­tants, in­clud­ing the Is­lamic State and the al-Nusra Front, have al­lowed th­ese im­mu­ni­sa­tion pro­grammes to op­er­ate in ar­eas un­der their con­trol as well, as they are not as­so­ci­ated with the As­sad regime.

The stance Is­lamist in­sur­gents take to­ward po­lio vac­ci­na­tion cam­paigns has less to do with anti-Western zealotry than with the spe­cific dy­nam­ics of the con­flict in which they are in­volved. This has im­por­tant im­pli­ca­tions for pub­lic-health pol­icy. Only by un­der­stand­ing the po­lit­i­cal con­text in which vac­ci­na­tion pro­grammes op­er­ate will those com­mit­ted to erad­i­cat­ing po­lio suc­ceed.

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