Did CIA undermine global health by faking vaccines in hunt for Bin Laden?

by hitthatswitch, Flickr

One of the chronic problems the international community has with almost every disease-fighting campaign has been the need to overcome mistrust — mistrust of government, of foreign health workers or outsider do-gooders in general.

This is, for a variety of reasons, especially true of vaccines.

So many worry that such global health efforts will suffer from the revelation, reported first in The Guardian and later by the New York Times and others, that the Central Intelligence Agency (CIA) set up a fake vaccination program in Pakistan in order to collect DNA samples. Says The Guardian:

The CIA organised a fake vaccination program in the town where it believed Osama bin Laden was hiding in an elaborate attempt to obtain DNA from the fugitive al-Qaida leader’s family, a Guardian investigation has found.

The CIA has refused to confirm or deny these reports.

Most of the media reports tend to focus on issues of terrorism, foreign policy and the increasingly strained relationship between the U.S. and Pakistan. There was little attention, initially anyway, given to the possibility that this CIA ruse could also seriously undermine a key tool in the worldwide battle against disease.

As anyone who has worked in the field in a foreign country on a vaccination campaign or other such project will tell you, establishing and maintaining trust is critical to success in public health.

Pakistan is one of those corners of the world where polio continues to spread. The infectious disease has been especially hard to stamp out despite a massive vaccination campaign because of gaps in immunization coverage in a few remaining polio-endemic countries.

With this news, it is perhaps not much of a stretch for many to predict that the polio campaign in Pakistan will have an even harder time reaching people in remote communities hostile to outsiders.

Beyond the impact on the polio campaign, some are concerned this CIA ploy is almost certain to fuel broader conspiracy theories and mistrust around any number of global health or humanitarian endeavors. Lives of health workers may be put at risk.

From the news reports, it appears the CIA didn’t follow through with the required number of doses needed for its own vaccination program — which was focused on preventing Hepatitis B — to be fully effective. In that sense, the CIA project was fake on a number of levels.

The damage done here will be hard to measure.

It’s not clear what the impact this revelation will have on the many efforts now underway in global health. But some in the aid/development blogosphere regard it as a major setback.

Mark Leon Goldberg at UN Dispatch specifically worries about the impact this could have on the polio campaign:

One of the great barriers to vaccination campaigns in these countries has been a stubbornly persistent rumor that the polio vaccine is a western plot to sterilize Muslim children…. This CIA ruse seems to confirm all the darkest fears that vaccination campaigns–particularly against polio–are part of some insidious American plot.

Brett Keller, a prolific global health blogger and grad student, describes the CIA project as “despicable” and calls for widespread condemnation:

Assuming the early reports are confirmed, this plot should be condemned by everyone. If US officials who support global vaccination efforts are going to control the damage as much as possible — though it’s likely much of it has already been done — then there need to be some very public repercussions for whoever authorized this or had any foreknowledge. What tragic stupidity: a few branches of the US government are spending millions and millions to promote vaccines, while another branch is doing this.

Chris Albon, who writes at Conflict Health, similarly says:

If true, the CIA’s actions are irresponsible and utterly reprehensible…. The simple fact is that the health of the children of Abbottabad has been put at risk through a deceptive medical operation by the Central Intelligence Agency.

Seth Mnookin, author of a book examining the anti-vaccine movement, The Panic Virus, calls this episode a horrible move with potentially dangerous consequences for global health.

It’s early days, but we have yet to hear anything from members of Congress or the Obama Administration about the strategy of using a public health campaign as a disguise for covert intelligence. Is this an acceptable trade-off in the war against terror? Or is it too potentially destabilizing to global health?

Will the global health community, especially those like Bill Gates who so vigorously promote vaccination as a “miracle” weapon against disease, speak out on this?

Clearly, many believe national security depends not only on winning the fight against the bad guys. Global stability and security depends upon many things, including maintaining a working level of trust and good will around the world — at least so we can collaborate when fighting common enemies like infectious disease.

Even the CIA has reported in the past on the benefit of promoting global health as a means to improve national security. The question now is if this episode will be regarded as an aberration or lead to further mistrust of U.S.-sponsored efforts in global health.

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About Author

Tom Paulson

Tom Paulson is founder and lead journalist at Humanosphere. Prior to operating this online news site, he reported on science,  medicine, health policy, aid and development for the Seattle Post-Intelligencer. Contact him at tom[at]humanosphere.org or follow him on Twitter @tompaulson.

  • Diego B

    I was shocked when I read this news this morning and truly hope all major players in the global health arenas will speak out on this issue. We do not need any more roadblocks for delivery of interventions anywhere, but this is especially true for conflict areas. This also adds fuel to all the insane conspiracy theories about vaccines and maybe in an even worse (and unheard of) way. Shame on the media too, for not presenting this angle and just lavishing on the core issue and not its long term consequences.

  • Funny how the CIA was able to do its job AND keep it secret, until the feat was accomplished.  Once the deed was done however, and details like this begin to emerge thanks to politicians, THEN the armchair spooks and intel-wannabe types can sit back safely in the comfort of their mommy’s basement and blog about how terrible it all is.

    So tell me, how many citizens of Pakistan, Iraq, and Afghanistan were blown up in the last five years compared to the number stricken by polio?  What would result in greater overall improvements in health for these communities, democracy or some UN/NGO vaccination drive?

    • Matty

      What a nasty comment.

    • Nasty comment indeed, and wrong on the facts. We’re criticizing their impact on public health efforts, not their spycraft — but since this wasn’t kept a secret they’re obviously not very good at that either.

      Just at a quick glance at WHO sources: in 1988 there were 350,000 cases of polio worldwide. That number is greatly, greatly reduced now — thanks to successful mass vaccination campaigns, the sort of effort that this CIA plot puts in jeopardy. The same WHO source also estimates this re: Vitamin A (which is often administered during polio campaigns): “Since 1988, more than 1.2 million childhood deaths have been prevented through provision of vitamin A during polio SIAs.” [http://www.who.int/mediacentre/factsheets/fs114/en/index.html]

      So, yes, global health efforts — which rely on public TRUST — have saved many, many times as many lives as have been lost in the wars of the last decade. A death prevented by a vaccine doesn’t get the same coverage in the news as someone killed in a suicide bombing, so your seat-of-the-pants math is wrong. And all this is discounting the fact that these things aren’t a zero-sum game; the CIA shouldn’t have to co-opt vaccination to accomplish its goals, and doing so is incredibly short-sighted.

    • RationalEar

      Wrong on cause / effect: 
      Yes, it would be great to reduce the blowing up of people.  That reduction will be increased by building trust not by eroding it.  Or is this a zero-sum world where for me to win I must make everyone else lose?

    • @ Ignorant Bryan

      If America had not destroyed the Pakistani secular education system in the 1980s, in order to create “madrassa” schools, then terrorism in Pakistan would not exist.

      If America did not betray Pakistan in 1989 by walking away, this issue would not exist.

      If the CIA did not train Osama bin Laden in 1980, the terrorism would not exist in Pakistan.

      The US Government is directly responsible for all the killings in Pakistan since 1979.

      So, please keep your “spycraft” to yourself.  Pakistan does not want you or need you.

  • American Liar

    Shame on America.

    This is why nobody trusts America.  Americans are liars.

    • Arthur_aficionado

      What do you want for free ?

      • American Liar

        Nothing.  Keep your American weapons and keep your worthless US dollars.  America is about to default on its debt and go broke.

        And please close the US Embassy in Islamabad and go back to America.

        Please take all your CIA and Mossad agents with you.  No Americans in Pakistan.

        The best relationship Pakistan can have with America is NO RELATIONSHIP.

  • Thank you for this post. Intentions and motives of international organizations/development agencies/NGOs are constantly questioned in a challenging environment such as Pakistan. Polio is on the rise in Pakistan and this debacle will not help the eradication campaign. Health based initiatives (and other development goals) will be met with great skepticism and cynicism. It will have a detrimental effect on addressing health issues on the ground here which is quite sad because the need for health reform is dire. We have to figure out a way/method to move forward positively that takes away from this sordid mess and focuses on the larger picture of meeting the health needs of people. 

  • Hacksolo71

    A very nuanced issue. Brattin makes a good point about weighing immediate danger vs. long-term health risks. Clearly, Osama bin Laden had to go. But that doesn’t excuse the stupidity of this vaccination/DNA collection scheme. The unmistakable and long term damage done to global health initiatives should have negated this plan or else the CIA should have ensured that the story never went public (I’m not advocating – I believe in Sunshine – but I’m also a realist). But at what point do the conspiracy theories cease being “nuts”? I mean, the Pakistanis have a “crazy” conspiracy theory about the CIA and a polio vaccine and here we are talking about the CIA using another vaccine for a DNA collection scheme. If I were a Pakistani parent, I wouldn’t see much of a gulf between CIA/vaccine/polio/infertility and CIA/vaccine/hep B/DNA collection.

    • It’s hard to make an “ends justify the means” argument when the means weren’t even necessary for the ends to be accomplished. From the reports so far it doesn’t sound like they were even successful in getting the DNA, yet they still went ahead with the attack. I don’t think it’s that nuanced — their decision might have seemed like a clever idea to them, but in the broader scheme it’s incredible short-sighted. It reminds me of the same sort of folks who thought it was a good idea to arm the muhajideen against the Soviets in the 1980s. Or the folks who thought it was for the greater good to conduct the Tuskegee syphilis experiment in the US. A small group of short-sighted actors can really ruin the efforts of those who are in it for the long haul — and we all pay the price.

  • Steve

    How many children around the world are going to die from preventable diseases because their families and communities don’t trust the vaccines being offered to them?  All to catch one old man.

  • Seansezz

    Killed Bin Laden!!! Lulz!

  • Marlycechilders

    Oh the stupidity. If you are going to do something that expensive and pointless, why not go ahead and give the vaccine, anyway?

  • Hmmm. I can only react to this discussion on a very visceral level, rather than pretend to have a handle on the actual impact this is likely to have in any empirical sense. That’s ok this time, because without more specific details about the fake ‘campaign’ this entire discussion is based on opinion and guesswork anyway, so here’s mine.

    First off, I am truly nervous of the impact that the anti-vaccine groups are having globally, and of their apparent ability to chip in whenever there is an opportunity to make their warped point in order to feed doubt, particularly on the internet (surprised there are no overt anti-vacc sentiments posted here yet, although maybe they don’t need to bother). Second, needlessly giving the anti-vacc folks another means to fan the flames of doubt is a stupid own goal by the CIA (what jerks). Third, and in my humble opinion, the ultimate impact of this alleged act by the CIA may be greater in relation to global health discourses on vaccination than it could ever be on local or national attitudes towards vaccination in Pakistan. But fourthly, and given my point 3 above, the feeling just won’t go away that the greatest causal factor in whole stupid scenario  will be people like us talking about what a shockingly idiotic thing this was for the CIA to do, raising the exposure of the event globally and converting it into additional units of doubt and mistrust as we do so. Amplify the issue, and I fear we make the resulting mistrust legacy bigger and bigger. In case we didn’t notice along the way folks, that’s the tactic of the anti-vacc blatherers: talk it up and sow the seeds of doubt.

    We should honestly ask ourselves what impact decrying this (ok, agreed, totally stupid) CIA act, after the fact, might have. If we loudly and publicly assume it will undermine public confidence in vaccinations, then it probably will. Do we really want to turn this into a notorious, Tuskegee-like vaccine debacle that anti-vaccs can talk about, and link to, for eternity?

    For the sake of balance, I would really like to hear the view from someone who works for UNICEF or the like, in Pakistan, who might have a more grounded view of the potential impact this is likely to have on all the dedicated work they have done to establish local vaccination campaigns there. I would like to hear about the success of the next polio day efforts in the country, or about the massive vaccination drive that the US government funds to make up for this. GAVI, what’s the best antidote?

    It’s done. We should just write and tell Obama he royally screwed up, and what he could do to fix it.