Pakistan

RECENT POSTS

Global health advocates celebrate polio milestone despite disease resurgence | 

Pakistani policemen stand guard as a health worker gives a child a polio vaccine in Karachi, Pakistan, Sunday, March 9, 2014.
Pakistani policemen stand guard as a health worker administers a polio vaccine in Karachi, Pakistan, March, 2014.
AP

This week, the World Health Organization certified that India and Southeast Asia was ‘polio free.’

Significant progress has been made against this crippling disease, with 80 percent of the planet now free from polio thanks to an aggressive global vaccination campaign largely led for decades by WHO, UNICEF, Rotary International and more recently supported – both financially and from the bully pulpit – by the Bill & Melinda Gates Foundation.

There is indeed cause for celebration, but also alarm.

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More attacks and polio cases harm Pakistan’s eradication effort | 

Pakistani security officials and relatives of tribal police assigned to guard polio workers who were killed in bomb blasts, pray next to the bodies during their funeral, near Peshawar.
Pakistani security officials and relatives of tribal police assigned to guard polio workers who were killed in bomb blasts, pray next to the bodies during their funeral, near Peshawar.
AP Photo/Mohammad Sajjad

The year is young, but Pakistan has already endured a serious of setbacks in riding itself of polio. Two new cases were confirmed over the weekend in Peshwar. Meanwhile, a bomb attack on a polio vaccination team left 11 dead and 12 wounded.

The fight against polio has been far more literal than figurative. Since December 2012, more than 40 people working with or for polio vaccination in Pakistan have died. The increase in cases of polio from 58 in 2012 to 91 in 2013 is attributed to the poor vaccine coverage in the country. Attacks on vaccine workers has only made it harder to reach young people.

Police vehicles carrying officers meant to protect polio vaccine workers were struck by a bomb on Saturday. A second bomb went off a few minutes later, when a new convoy was sent in response to the first attack. A firefight ensued between the surviving officers and the unknown gunmen.

“An Attack on security personnel providing security to Polio Teams is an attack against Humanity,” said the Prime Minister’s Focal Person on Polio, Aysha Raza Farooq, in a Facebook post following the attacks. “Such coward attacks and conspiracies against our goal of Polio Free Pakistan will further strengthen our resolve to stamp this menace out of the country.”

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Taliban attitudes changing amid renewed polio vaccine worker attacks | 

Pakistan Polio
A Pakistani health worker, left gives a polio vaccine to a child, who was displaced with his family from Pakistan’s tribal areas due to fighting between the Taliban and the army.
AP Photo/Muhammed Muheisen

Consecutive days of attacks on polio vaccination workers in Pakistan renewed concerns about its eradication. At least ten people were killed during attacks on Tuesday and Wednesday, this week. Despite that, Changing public attitudes by Taliban leaders may indicate a coming decrease in attacks.

Gunmen on motorcycles opened fire on a vaccination team in the city of Karachi, killing three members and injuring two. The following day, a police van carrying guards for vaccine workers was bombed in the northwest. At least seven people were killed as a result, including one child, said local police.

The police said that it will continue to provide security support for vaccine workers in the region. While neighboring India celebrated three years polio-free, Pakistan saw polio cases nearly double in 2013 to 91 cases. The northwest of Pakistan has struggled with reported cases of polio caused, in part, by the difficult circumstances facing vaccine campaigns. The Taliban have been a strong opponent to vaccines, citing fears of spying and harming children.

UNICEF estimates that 32 polio health workers have been killed across Pakistan since the middle of 2012. Continue reading

Law & Order: Poverty alleviation unit | 

Gary Haugen
Gary Haugen

(New York) – Movement inside of the Sheraton Hotel, location of the Clinton Global Initiative meeting, came to a standstill as President Obama exited the building.

Press and meeting attendees left at once, flooding the lobby of the hotel. A swarm formed in front of the elevators as people tried to predict which door would open first and ensure that they would board to head upward.

I made it up to the fifth floor when the elevator behind me arrived at the lobby. After being cleared by the Clinton Foundation volunteer gatekeepers, wearing white shirts and adorned in CGI branded scarves or ties, I was escorted to one of the conference rooms.

Gary Haugen, founder of the International Justice Mission (IJM), jumped up to greet me as I apologized for my tardiness. He offered his forgiveness with a flash of his gap-toothed smile. A former Department of Justice lawyer, Haugen wears his grey hair in a flat-top style that taunts gravity’s pull.

He led the UN investigation following the 1994 genocide in Rwanda. The research and his human rights work led to the founding of the International Justice Mission (IJM) in 1997. He discovered that violence is one of the core problems related to poverty.

“The thing you notice is this massive level of violence against the poor in the developing world and the way it undermines their development and opportunity to get out of poverty,” he explains. Continue reading

Polio is a proxy for chaos | 

polio vaccine

Sanofi Pasteur

The polio virus, as it is frustratingly inclined to do, has rebounded again despite the ongoing, determined effort aimed at worldwide eradication.

Like the game whack-a-mole, polio is popping up again in locations that we thought had gotten rid of it for good – like Israel or eastern Europe.

This happens because the virus is good at cloaking itself, sickening only about 10 percent of those infected and spreading primarily due to poor sanitation or hygiene (i.e., the highly unappetizing path of transmission known as the ‘oral-fecal’ route). But that’s the purely epidemiological, health-focused explanation.

The main driver, arguably, for the recent surge polio cases is conflict, instability and, of course, ongoing poverty. Continue reading

Vaccinophobia: World’s most powerful disease preventing tool, the vaccine, still a hard sell | 

A shot at life

UNICEF

A shot at life

The benefit of expanding the use of vaccines worldwide seems like a no-brainer: A cheap and easy way to stop disease dead in its tracks.

Yet polio persists despite a massive global campaign. The crippling disease is back in the Horn of Africa and new violence against vaccinators in Pakistan prompted the World Health Organization to again suspend its polio immunization work there.

The ups and downs of the polio campaign is a cause for concern to those seeking to eradicate this disease. But it isn’t just polio vaccines, or vaccinators, in poor countries that are targeted. There’s a disturbing synchronicity among vaccine opponents – whether it’s the Pakistani Taliban, Nigerian Islamists or Seattle granola heads. Seattle, in addition to being an epicenter for global health, is also known for having the lowest rate of child vaccination for any US city.

Part of the problem may be that a vaccine’s benefit is invisible on the individual level – lack of death and disease. Perhaps another reason vaccines are so frequently targeted for boycotts is the contagion of scientific illiteracy. Continue reading

A renewed push to ban spies from overeas health and aid work | 

Is it foreign aid or covert aid?
Is it foreign aid or covert aid?
Flickr, johanoomen

Co-authored by Tom Murphy

The latest assassination of health workers vaccinating kids against polio in Pakistan may be the tipping point.

Or not.

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.

Frumkin“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.”

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We must end polio – if only so Bill Gates can talk about something else | 

That sounds flip. But it’s not meant to undermine the global campaign to eradicate polio or (continue to) irritate the media folks at the Gates Foundation. It’s meant to underline the frustration I assume Bill Gates and many other advocates of this important global health goal must feel, even if they don’t say so.


News analysis (of sorts)

Today, at the United Nations, Bill Gates, heads of state from the polio-plagued countries Pakistan, Nigeria and Afghanistan, the head of the UN, the fiesty chief of the World Health Organization and other ‘global luminaries’ today repeated the call to push on with the ongoing effort to rid the world of polio.

UN Secretary-General Ban Ki-moon said that the world is at a decisive moment and that he has made polio a “top priority” for his second term.

“Failure to eradicate polio would be unforgivable…. Failure is not an option,” said Dr. Margaret Chan, Director-General of the World Health Organization. India was recently declared polio free, a major achievement for the campaign.

Gates Foundation

Bill Gates and Jeff Raikes in Nigeria for polio vaccination

“The evidence is clear: if we all do our part, we can and will end this disease. But we must act quickly and give ourselves the very best chance to succeed,” said Gates, who had earlier explained on his personal blog why he flew 3,000 miles to speak for three minutes at this somewhat predictable event. “When we defeat polio, it will motivate us to aim for other great health and development milestones.”

Yeah, yeah. Same old stuff. But that last statement by Gates is key.

Chances are, this particular dog-and-pony show among all the other UN dog-and-pony shows — despite the alleged luminaries — may get only passing notice because, well, most people don’t really care about polio. That’s why they bring out luminaries – to get you to pay attention.

(NOTE: The first news report I saw on this gathering of luminosity was an AP story in which the reporter at the polio event asked Gates what he thinks of the new Windows 8 operating system. Gates said, “Very exciting.” No word if the journalist asked about polio….) Continue reading