Politics of Polio
The polio vaccination drive should be reshaped in such a manner that it comes across less as a foreign effort and more a local one.
Pakistan’s inability to curb polio could mean a rise in travel restrictions for its citizens.
In Pakistan, administering polio drops to children is perilous work. In the last few months, volunteers and workers of the UN-backed anti-polio drive have been targeted and killed in Peshawar and Karachi. In Waziristan, the Taliban have gone so far as to ban immunization altogether.
Pakistan is one of the three countries in the world that still have a polio problem. While neighboring India has been polio-free since 2011, Afghanistan, Nigeria and Pakistan have yet to defeat this infectious, potentially deadly disease.
The statistics are grim. According to the World Health Organization, 85 cases of polio were reported in Pakistan in 2013; a significant rise from the 58 that were recorded in 2012.
It doesn’t help that defeating polio has become a deeply politicized issue in Pakistan. The seemingly innocuous anti-polio campaign met with a massive controversy when news broke that Dr. Shakil Afridi had run a fake vaccination program in Pakistan to help the CIA close in on Osama bin Laden. This revelation, combined with the persistence of the massively unpopular U.S.-led drone strikes on Pakistani territory, has led to a widespread distrust of polio vaccination efforts in the country.
Deeply conservative elements view immunization with suspicion, regarding it as a ploy to make the Pakistani population sterile. The result is that driven either by fear or distrust, parents in many parts of the country refuse to get their children vaccinated against polio.
Faced with intimidation from militants, health workers operating in various areas of the country have halted work until security is stepped up or the ban rescinded. The upshot is that thousands of Pakistani children remain exposed to this disease that can cause lifelong paralysis.
It is estimated that above 163,000 children in the region, who are below five years of age, may be affected by the anti-polio ban. Additionally, the country’s inability to curb polio could mean a rise in travel restrictions for its citizens. Already, India requires visa applicants from Pakistan to provide proof of polio vaccination. Other countries are expected to tighten policies in this regard as well.
Nonetheless, a combination of local politicians, clerics, social workers and celebrities has pushed for Pakistan’s anti-polio campaign to continue undeterred. Imran Khan, whose party controls the provincial government in Khyber Pakhtunkhwa, has pledged support for the campaign. Lending religious authority to these efforts, prominent cleric Maulana Samiul Haq has issued a fatwa urging parents to immunize their children against polio. Government officials have also stated their commitment to defeating the disease.
These are important steps towards revitalizing the drive against polio but they are not enough.
Pakistan cannot afford to nurture polio. Its failure to eradicate the disease deals another blow to child health in the country and endangers the prospects of global eradication of polio – reinforcing Pakistan’s status as something of an international pariah. Concerns have been raised about Pakistan exporting polio and setting back hard-won progress made by other countries.
To crush polio, Pakistan must first beat the propaganda surrounding polio vaccination. What it needs now is to reframe the polio debate, highlight medical truths and separate them from rampant misinformation. It must also address legitimate concerns about the living conditions that cultivate polio and other diseases – such as poor sanitation, malnutrition and lack of health services in the poorest parts of the country.
The job will not be complete with the act of administering polio drops to every child in the country – although this will indisputably be an important milestone. Basic health services also need to be made available to them, both as a confidence-building measure and as a sensible way to sustain gains in the area of health.
Polio can only be defeated through a firm political will at the highest level and strong local cooperation. It is important to call on religious leaders with a huge following to rubbish the argument that seeking vaccination is an unnatural act of defiance and that polio is something good Muslims are destined to live with. Denying children vaccination cannot be passed off as an act of religion in a country where religion is taken quite seriously and informs many personal decisions.
A powerful public information campaign must focus instead on the terrible consequences of polio and the fact that the disease can and should be prevented. It should be designed to build acceptance of polio vaccination among local communities.
Additionally, the government must assert its writ and refuse to allow the anti-polio campaign to be hijacked by militants. This will mean tightening security provisions for health workers and making it possible for them to go about their work unharmed.
Being mindful of the negative perception of the U.S. and the UN in the remote parts of the country, concerted efforts should also be made to reshape the campaign against polio in such a manner that it is seen as less of a foreign effort and more of a local one. It is important to get local leaders
of every district to extend their support to the campaign against polio.
There is another facet of Pakistan’s polio dilemma that underpins a larger, very disturbing, socio-political trend in the country – its fixation with bans. From Youtube to polio drops, anything that offends sensibilities is outlawed in Pakistan.
Prohibition is a quick solution to quell divergence or anything remotely problematic. However, the absurdity of this approach is all too apparent when the same formula that is applied to curtailing pornographic material is also applied to life-saving drops.
Pakistan’s failure to find ways to cope with dissent and controversy have given birth to a culture of banning that begs a rethink. How long can exclusion and evasion be the knee-jerk response to a debate? Is it viable to allow critical matters of public health to be held captive to the politics of distrust and otherness?
This is the larger question that the government needs to address. When efforts to root out polio among our children can be subjected to bans, which critical aspect of healthcare or national welfare could be banned next?
The government can only establish its legitimacy by removing all needless bans that threaten the well-being of our people.