Co-authored by Tom Murphy
The latest assassination of health workers vaccinating kids against polio in Pakistan may be the tipping point.
It remains to be seen if a new surge of efforts — a letter of protest from leading public health experts, a petition — asking the Obama Administration to prohibit spies from pretending to be overseas aid and health workers will force a change in policy.
Such protests didn’t even garner an official response the last time.
When it was learned in mid-2011 that the CIA had conducted a fake vaccination scheme in Pakistan aimed at gathering evidence to locate the then still-alive-and-in-hiding Osama Bin Laden, many in the global health and humanitarian community (including Humanosphere) cried foul and predicted a lot of collateral damage.
The problem, said 200-plus aid groups in a letter of protest sent by Interaction, was not just that this would undermine international vaccination projects in Pakistan, which it arguably did in this nation with one of the world’s highest rates of polio and other infectious diseases.
Many experts said it would more broadly undermine trust and credibility for all humanitarian work – and likely endanger aid workers. Many of these tragic predictions have since come true, prompting many in the global health, aid and development community to push again for policy prohibitions against such schemes.
“Public health programs overseas offer a very special opportunity … as a bridge to creating peace and mutual understanding,” said Howard Frumkin, dean of the University of Washington’s School of Public Health and a signatory to the letter of protest sent by leading health academics to President Obama. Unlike many other kinds of aid and assistance programs with inherent political or economic complications, Frumkin said, health initiatives done correctly overseas can forge intimate bonds of trust and respect for life that transcend politics.
“This is why it’s so important not to subvert the credibility and integrity of these kind of health programs,” he said. “The recent killings in Pakistan only underline the importance of keeping our intelligence activities separate from our health aid and assistance work.”
That is the goal of a new petition (created on the White House website!) launched by Brett Keller, a public health and policy graduate student who is also a popular blogger in the aid and development community. Keller said he is basing the petition — which needs 25,000 signatures — primarily on a policy paper that made the same call a month ago, written by Charles Kenny of the Center for Global Development:
“Given the vital importance of global child vaccination programs to US national security interests, and the chilling effect of allegations regarding links to US intelligence operations, intelligence-community use of child public health service provision as part of operations should be explicitly banned,” wrote Kenny.
Keller adds: “I know there must have been global health folks in the administration cringing at the situation. But without public outrage, how can they stand up against the cynics who came up with the ploy in the first place? Basically, we need to generate a public showing that those of us interested in health around the world were deeply offended by this.”
Much of the criticism of the CIA ruse has been on the negative impact it has already had on the global effort to eradicate polio.
Polio is on the verge of eradication globally, with only three countries (Afghanistan, Nigeria and Pakistan) still considered to be endemic by the World Health Organization (WHO). India appears to have rid itself of polio but the infectious disease presents a global risk as long as it continues to infect children anywhere.
The information gathered during the campaign reportedly provided valuable intelligence that led to the raid which left bin Laden dead. But when it was revealed in mid-2011 that the CIA had used a local doctor, Shakil Afridi, to coordinate a Hepatitis B vaccination campaign as a means to collect DNA looking for bin Laden family members, Afridi was arrested for treason and health campaigns either pulled out or had to deal with increased security risks.
Previous concerns in Pakistan that vaccination campaigns were attempts to sterilize Muslims were amplified by the CIA’s actions. The Taliban issued a vaccination ban in the tribal region of Waziristan in June 2012. Drone strikes in the region caused Taliban leaders to believe that aid workers were spying for the United States. “Militants’ fear that NGO or health workers could be spies, may be spreading into other realms,” the Pakistani foreign office told IRIN news service recently.
Attacks on aid workers began a month later when armed men opened fire on a WHO vehicle in Karachi, wounding a doctor and his driver. Then, a series of attacks on polio vaccination workers in mid-December left 9 aid workers shot dead – and to the suspension of the vaccination campaigns by UNICEF and WHO. The new year began with further attacks on aid workers that left seven aid workers dead on January 1 and another two were killed in Charasadda on January 4.
“We had never received a direct threat, since we began work in the early 1990s,” Javed Akhter, executive director of SWWS, an NGO that lost seven workers on New Year’s day, told IRIN, adding however that “other NGOs in the Swabi area have felt a sense of intimidation.”