Three reasons why CIA faked vaccines may cause contagion of damage

New Action Thriller: From UNICEF with Love?
Flickr, johanoomen

Now that the CIA has acknowledged running a deceptive, if not totally fake, vaccination program in Pakistan as part of the effort months ago to hunt down Osama bin Laden, here are three reasons why this episode is prompting an angry response by those who work against global poverty and disease:

  1. This isn’t just about vaccines — about fighting terrorism vs fighting polio.
  2. Health workers and aid workers overseas have to be seen as neutral and independent if they are to operate effectively and safely.
  3. National security isn’t achieved just by hunting and killing bad guys. It’s also achieved through humanitarian efforts, aid efforts and other forms of international collaboration based on mutual trust.

So let’s review where we are so far with the strange case of “The Immunizer of Abbottabad.”

After The Guardian on Monday first revealed this bizarre scheme aimed at collecting DNA from bin Laden family members, the CIA apparently has confirmed to the Washington Post that it did set up the vaccination program in northern Pakistan. Here’s what some anonymous official reportedly told the newspaper:

A senior U.S. official said the vaccine campaign was conducted by medical professionals and should not be construed as a “fake public health effort.”

“People need to put this into some perspective,” said the official, speaking on condition of anonymity because of the sensitivity of the issue. “The vaccination campaign was part of the hunt for the world’s top terrorist, and nothing else.”

“If the United States hadn’t shown this kind of creativity, people would be scratching their heads asking why it hadn’t used all tools at its disposal to find bin Laden.”

Actually, many seem to be scratching their heads asking how the Central Intelligence Agency (given its middle name) came up with such a far-fetched scheme — it doesn’t appear to have worked — and how it can argue with a straight face that this was, in addition to a covert op, a legitimate vaccination program.

To begin with, just giving kids a real Hepatitis B vaccine doesn’t mean it’s not fake public health.

A number of reports have said the children in Abbottabad did not receive the full course of vaccination (three doses) against the disease. Since it was a covert operation, and the Pakistani doctor recruited by the CIA has been arrested for cooperating with the spy agency, there is no reliable documentation on the immunizations.

As Alanna Shaikh says in her article for Foreign Policy A Shot in the Back:

First off, hepatitis B is a real worry in Pakistan, and one dose in a three-dose series will only provide a tiny amount of protection to those children. There’s almost no chance now that these kids will even finish the vaccination series — and many, many thousands more will likely steer clear of future programs of this sort, no matter how legitimate.

So, based on what we know, it was indeed a fake immunization program since the goal appears not to have been to make these kids immune to this infectious disease that causes a lot of liver failure, cancer and other problems in poor countries (or anywhere, for that matter).

After perhaps a few days representing stunned silence, or waiting for the story to be confirmed, many leading organizations or individuals within the global health and aid community are beginning to react and speak out.

The primary concerns expressed are that this episode will make it harder to get kids immunized, especially in the difficult fight to wipe out polio in Pakistan.

Sarah Boseley of The Guardian writes, in Collateral Damage from the hunt for Bin Laden about what happened years ago in northern Nigeria and how mistrust of the vaccine there caused polio to explode:

In that northern, Muslim region of Nigeria, there was a dramatic loss of confidence in the polio vaccine after rumours spread that it was part of a plot by the US to make Islamic children infertile. It took a huge effort to rebuild trust, aided by senior Muslim clerics and scholars who visited Kano to reassure people that the vaccine was entirely benign.

Similarly, Maryn McKenna in Wired warns that the CIA ruse could actually do more than just cause harm in Pakistan. The rumors in Nigeria were false, McKenna notes, while what the CIA has now admitted doing is material evidence for the conspiracy theorists and anti-vaccine crowd:

The accusations that polio vaccination was a Potemkin cover for anti-Islamic activities almost ruined the international eradication of polio when they were false. Now, on the basis of the CIA’s alleged appalling ruse in Pakistan, they may be made again. And they will be much more believable, because this time they might be true.

With the perhaps unintentionally humorous headline, Fact Check: Vaccination not a CIA front usually, this AP article notes that the Obama Administration in 2009 actually had to reassure three Muslim nations that immunization was not a CIA plot in order to gain acceptance for our foreign aid programs pushing against polio and other infectious diseases.

But the move directly contradicts the administration’s own message to the Muslim world. And health experts say maintaining confidence in vaccination drives is far more important than even the hunt for bin Laden…. The expanded polio vaccination effort was seen as a key to success for the Obama administration’s Global Engagement Directorate, which is run out of the National Security Council.

As I wrote earlier, it will be difficult to assess just how much this CIA escapade damages immunization programs worldwide, or global health projects in general. There’s no simple way to diagnose and track mistrust. But many, like Doctors Without Borders, predict mistrust will increase and humanitarian efforts — if not the humanitarians themselves, as suspected spies — will suffer.

And many others, like James Fallows in The Atlantic, predict the potential damage could reverberate well beyond the global health or vaccination arena:

Around the world this will touch the very deepest sources of mistrust, fear, and hatred of the big, technological United States. We will (in this narrative) lie to people about basic questions of family health; we will prey on parents’ concern for their children to lure them into situations where we can take samples of their tissues and fluids; we will say one thing and do another — under white medical-technician jackets and a humanitarian guise. We will suggest that no aspect of our international presence is immune to penetration by spies.

The global health and aid community is beginning to speak out, largely to condemn this CIA project as ill-conceived and potentially damaging to immunization and international health efforts. Some see it, like Fallows, as having much broader, destabilizing consequences.

So far as I can tell, we have yet to hear from many in Congress or anyone in the Obama Administration, which frequently says it sees foreign aid and specifically these kind of global health efforts as critical to our national interest, on this episode.

Was this an acceptable compromise — of the integrity and independence of public health, not to mention the personal safety of aid workers — or a terrible mistake with many unforeseen consequences to come?


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] or follow him on Twitter @tompaulson.

  • c

    Huh. CIA programs that don’t work and cause more damage locally and globally than achieve U.S. aims? (There is no such thing as universal global “good”) Truly shocking, LOL. The thing the CIA does best is kill unarmed citizens from thousands of miles away with drones and sell old military technology to U.S. allies. If they were so good at their job, they would have found Bin Laden years ago…I’m not saying it was easy, I’m just saying we wasted a lot of time and money killing one person while we still can’t stabilize either of our military colonies’ territory in Iraq or Afghanistan. Bin Laden’s death has turned him into a martyr. By the way: Hundreds of bases and permanent garrisons = military colonization.

    • Ngongro

      This is a knee jerk uninformed opinion. There have been critical mistakes made
      by the CIA. Destabilization of Iraq was the Administrations headache.

  • bmull

    I can’t believe that this is not a war crime. It is inconceivable that children won’t get sick and die from a preventable disease because of this operation.

  • Anonymous

    This deception by our CIA is so wrong that it defies appropriate terminology. So they pulled off a Hollywood style caper and killed bin Laden. Other than a macho kick-off to Obama’s reelection campaign, what was the big deal? Videos show bin Laden as a prematurely aged, diseased, defanged man collecting porn and hatching small, totally implausible plots. He was done. War-weary, debt-ridden, jobless Americans seldom gave bin Laden a thought. Another example of how out of touch D.C. is with the people it supposedly serves. David Petraeus, who has always been on the government dole and has lived in his own wonder world, is arrogant enough to see himself as the “intelligence” in the agency, and he is the perfect man to run it.

  • Bluebird

    In Nigeria, at least, it looks like a patronizing attitude towards Nigerians reporting the initial indications that the live polio vaccine virus has reverted to virulence is what radicalized the population.  Per an exchange between a renowned virologist and a westerner living in the region at the time:“M: I distinctly and clearly recall the BBC featuring an
    extensive interview with a representative of the WHO at the time of the
    Nigerian boycott sneering and scoffing and mocking the absolutely
    “preposterous” notion that there could be ANY relationship between this
    vaccination and infection with polio. In fact the BBC speculated that
    since this revolt against the vaccination program occurred in the north
    of the country, it could well be part of an al Qaeda strategy of
    This line of scorn and derision was repeated throughout the AP and Reuters at the time as well.”
    P: For many years the WHO line was that vaccine-derived polioviruses
    could not cause polio, nor could they be transmitted among humans. The
    outbreak of vaccine-derived disease in 2000 in Haiti and subsequently in
    several other countries changed that incorrect view.”
    M: I understand and agree.
    But as an informed layperson I could tell at the time that there was
    at least a shred of competent anecdotal evidence to the contrary.
    And for such a prominent body to heap scorn on those who disagreed in
    good faith only contributed to the polarization in Northern Nigeria.
    This phenomenon is NOT unrelated to the strengthening of radical Islam
    in that area and now al Qaeda is establishing a foothold and more there.
    The end result of this very important event in recent northern
    Nigerian history is that the credibility of the radical Islamists in
    that region was dramatically increased among the local population.
    That’s a horrific outcome and heads should roll because of it. The
    people of Northern Nigeria are hot as Hades about the entire episode, as
    they well should be.
    I remember hearing a local leader speaking on the subject at the
    time. I was expecting to hear some blathering idiot, which is how the
    BBC treated his commentary. But after listening carefully to his views, I
    could not exclude the possibility that he could be at least partially
    correct. I was stunned. It seemed that there was just too much smoke
    there to exclude further inquiry. Something was clearly going on.
    At the time, I recall polio was on the ropes. This was the last area
    in the world, to my knowledge, where polio existed. Then I watched over
    the years with horror and dread as it reappeared in several nations.”

    • Alanna Shaikh

      Opposition to the polio vaccine in Nigeria is based in Kano, which was also the area used as guinea pigs without consent for a meningitis treatment. I always thought that was what turned the imams against vaccines.

  • The Sanity Inspector

    I don’t care.  The people of Pakistan murder our aid workers, shelter our enemies, and constitute a failed, dangerous state. 

    • protectedstatic

      Way to miss the point… This is larger than Pakistan. Also, generally, it’s a pretty good idea to be concerned with how you deal with a nuclear power.

  • courtneyyyyyy

    Epic fail.