The all-out global war against polio takes a strange turn in Pakistan. Pakistan polio eradication efforts have become enmeshed in the long-running conflict between Pakistan’s central government and the Pakistani Taliban, which is concentrated in the area that is now the focus of the government’s anti-polio campaign.
Today, thirteen people, including 12 security guards, were killed by two roadside bombs and heavy automatic rifle fire in an attack on a polio vaccination team. Eleven others were injured in the attack. None of the aid workers were killed in the attack, which took place in the Lahore area of Jamroud Tehsil in Khyber tribal district, 30 kilometers (18 miles) southwest of the city of Peshawar.
The dead were members of the Khyber Khasadar Force, a local police force from the Khyber community. The paramilitary Khasadar force was guarding a convoy of three vehicles carrying polio aid workers as part of a three-day nationwide campaign to administer an oral anti-polio vaccine to area children. One child died in the attack.
“The bombs exploded after the first vehicle that was taking Pakistan polio workers crossed the spot,” an official told a local newspaper. One vehicle was destroyed and two others were damaged in the attack. The official added that there was no question that the attack was aimed at the polio vaccination team.
The attack in Landikotal was the latest in a series of attacks against polio aid workers, which followed months of militant strikes and threats of violence against the program. More than 40 people, including health care workers and security guards, have been killed in Pakistan since December of 2012 by unknown assailants, who are apparently displeased with the country’s aggressive anti-polio vaccination program.
Two other Pakistan polio vaccination teams have been abducted in separate incidents. A six-person vaccination team was abducted in the area southwest of Peshawar at the beginning of February. Their whereabouts remain unknown. A second six-person polio vaccination team, kidnapped in southwestern Pakistan last week, was released after two days following the intervention of local tribal elders.
Pakistan is one of three remaining countries, along with Afghanistan and Nigeria, where polio remains endemic. A fourth country, India, recently celebrated the success of its polio vaccination efforts with no new cases of the disease in a 36 month period. Pakistan’s results have not been as good, with 91 cases of the disease being reported last year, up from 58 cases reported in 2012.
The World Health Organization targeted Pakistan because the Peshawar, the main city in northwest Pakistan is “the world’s largest reservoir” of poliomyelitis. Pakistan’s failure to eradicate the disease in the face of arch-rival India’s success has resulted in increased efforts by the provincial government to impose the polio vaccination efforts on the tribal areas, where local rule is especially strong and tribal traditions against vaccinations of any kind are deeply ingrained in the culture.
The vaccination program aims to inoculate more than 600,000 Pakistani children against nine different diseases, including polio. Faced with widespread resistance to the inoculation program, the regional government in Peshawar deployed some 40,000 security officers in an effort to protect Pakistani polio aid workers. This, in turn, has it made it appear as if the polio eradication campaign might be an excuse to infiltrate troops into areas controlled by the Taliban, which may be what triggered the attacks against the unarmed aid workers.
No one has claimed credit for any of the attacks. Pakistani authorities suspect Islamist militants who have their strongholds in the Tribal Territories, where there is a widespread belief that the vaccination campaign is a cover for the infiltration of Western espionage efforts into the region, which has long been hostile to all outsiders.
Another persistent rumor, which may have crossed over from India, where the same vaccination program was initiated more than seven years ago, suggests that the oral vaccine causes infertility. No explanations have been offered for this belief since the vaccination program has not been going on long enough to have a perceptible impact on human fertility in the region.
It is more likely that stories have crossed the border with India about a significant number of cases in which Indian children who have been treated with the oral vaccine have come down with less severe polio-like symptoms shortly after being vaccinated. There is a known incidence of one in 750,000 where the vaccine does appear to infect children with a milder form of the disease, but unnamed Indian sources have claimed that 47,000 Indian children were stricken with the condition.
If true, that would make the vaccine several times more dangerous than polio itself, since only 1 percent of the children who are exposed to the polio virus eve become symptomatic, and only 1 percent of that 1 percent develop debilitating symptoms from the disease. There have been no official reports pointing to such a widespread condition, but rumors are never bothered by the absence of evidence.
The attacks against the Pakistan polio vaccination teams have taken place within an environment of escalating violence between the government of Pakistan and the Pakistani Taliban, who are the primary suspects in the attacks against the polio program. Since the Taliban views the central government of Pakistan as part of the Western world they are fighting against, it is possible that they view the efforts to conduct the vaccination program as a covert information gathering campaign aimed at the Taliban itself.
Today, the Pakistani Taliban command issued orders for a one month moratorium in the guerrilla campaign against the central government to give the negotiators a chance to bring peace to the country. This may mean that the attacks on polio vaccination teams may end, but that will be hard to determine, since the provincial government in Peshawar has called for a moratorium on the vaccination program until the violence in the region cools down. The Pakistan polio eradication project may have to wait for Pakistan and its Taliban to agree to a long-term cease-fire. Unfortunately, the polio virus won’t wait.
By Alan M. Milner