Memo to public health workers: don’t moonlight for the CIA. Things could go pear-shaped. This may seem obvious, but the use of a CIA-organised vaccination campaign in the Pakistani city of Abbottabad has led to a polio epidemic. On May 20, a White House official wrote to the deans of 12 American public health schools to inform them that the CIA had agreed not to use public health as a cover for espionage.
The roots of the epidemic lie in the CIA’s search for Osama bin Laden. To confirm that he was in his Abbottabad compound, it recruited a local doctor, Shakil Afridi, to run a hepatitis vaccination drive. After bin Laden’s assassination in 2011, Dr Afridi was arrested and sentenced to 33 years in prison for treason. (This was later overturned and he is awaiting a retrial.) Vaccination campaigns were completely discredited; health workers promoting polio vaccination were murdered; the Pakistani Taliban banned vaccinations; and the disease spread.
Polio was almost beaten, but now the World Health Organisation has declared its spread an international public health emergency. The Lancet summed up the tragedy:
The lesson learned from the experience in Pakistan is that public health programmes should be politically neutral. Although the announcement from the White House might go some way to building bridges towards that neutrality, health officials and local leaders now have the challenge of convincing communities that vaccination is not merely beneficial, but vital for children.
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