Posted by Anaïde Nahikian on August 21, 2012  |   Comment  |   Subscribe

 
The ongoing fight against polio in Pakistan has suffered a significant setback, as Taliban leaders in the tribal areas have banned all vaccination programs in the region. Hafiz Gul Bahadur, a prominent commander of a Pakistani Taliban faction in North Waziristan, has prohibited anti-polio immunization campaigns in protest of ongoing U.S. drone attacks, prompting leaders in other tribal areas to do the same.
 
Last year, 198 polio cases were reported in Pakistan — an increase from the 144 reported in 2010 — making 2011 one of the “worst performing years fighting polio in more than a decade”, despite the government’s recent introduction of a National Emergency Plan and a task force to combat the disease. The high prevalence of the disease has been stated a “national emergency” and triggered renewed international and local anti-polio efforts, particularly in tribal areas. Now, as government officials try to negotiate with tribal leaders, 240,000 children will likely be affected if polio drops are not administered in North and South Waziristan. Gul Bahadur has announced that anti-polio teams would be granted access into the tribal belt only if and when U.S. drone strikes stop.
 
In addition to the ongoing controversy surrounding the U.S. drone strikes in Pakistan, the anti-polio program ban comes in the wake of the recent sentencing of Dr. Shakil Afridi. Afridi was found guilty of treason for assisting the Central Intelligence Agency (CIA) in locating Osama bin Laden’s compound in Abbottabad under the cover of a vaccination drive. As a result, suspicion about health workers has increased, and Taliban leaders have used this incident to promote their position on the ban. Evidently, humanitarian agencies have felt the fall out in Pakistan following the CIA implicating aid workers in its operations, which undermines the humanitarian principles of neutrality, impartiality, and independence; fuels existing political tensions; and leads to the obstruction of life-saving assistance.
 
This situation presents a number of challenges for humanitarian teams in Pakistan, particularly those engaged in vaccination campaigns. America continues to defend its drone program on the basis of the existence of an armed conflict with Al-Qaeda and the U.S.’s right to self-defense, while the Taliban continues to fervently argue against the strikes. Local spokespersons argue that the citizens of Waziristan ought not receive “benefits from such a benefactor who spends billions on the eradication of polio on the one hand, but also kills people on the other.” Furthermore, the Taliban argues in a pamphlet that it recently published that the continuous drone strikes physically and psychologically harm far more innocent civilians than does polio.
 
In the midst of this political deadlock, some argue that withholding critical preventive medical treatment for innocent children for political purposes is unacceptable. A process of mediation at the political level between local Taliban leaders, the Pakistani government, and humanitarian agencies will be necessary to ensure that the children of these tribal areas will no longer be the victims of political power-play. According to Dr. Bruce Aylward, Assistant Director-General of Polio, Emergencies and Country Collaboration at the World Health Organisation (WHO), those living in these regions will “come to understand that their children are now the only children in the world at risk of being paralysed for life, and that the local leaders hold the future of those children in their hands.”
 
Mediation at the leadership level will facilitate the safe access of health professionals in the tribal regions, allowing humanitarians to negotiate clear terms of access for vaccination and ensuring that agencies are able fulfill their mandates while simultaneously maintaining the security of their staff in restricted environments. Professionals should come to a consensus regarding their current activities in the tribal regions and determine a set of protocols for effective vaccination where possible. At the local level, according to Aylward, this means addressing the primary concerns linked to these programs, fully engaging local health workers in vaccinations, and developing an approach that is appropriate and sustainable in the intended communities, in order to finally eradicate this preventable disease.