Yesterday, my friend Zizi and I watched the documentary Every Last Child at Angelika Pop-Up at Union Market, a cozy arthouse that screens an array of indie cinematic productions. A little over a mile from Capitol Hill, this theater and Union Market are wonderful for the DC intern and resident alike.
The documentary tracks progress of the polio vaccination campaigns in Pakistan. Polio is a contagious viral illness leading to paralysis and often death. Although the disease was eradicated in the United States in 1979, approximately 416 cases remain worldwide (WHO) in three countries: Nigeria, Afghanistan, and Pakistan–yet cases are mostly concentrated in Pakistan. Having already introduced the idea of vaccine confidence in my previous blog post, I am now analyzing low polio vaccination uptake in Pakistan through a sociopolitical lens. In 2012, the Taliban banned polio vaccinations for reasons that are far from scientific. Here is my understanding of the determinants of the overwhelming hesitancy towards polio vaccination in Pakistan:
1. The international public health scandal in which the CIA hired Shakil Afridi, a Pakistani surgeon, to obtain information about Osama bin Laden under the guise of a hepatitis immunization survey in Abbottabad, where bin Laden was later killed. The project was founded to obtain DNA from bin Laden’s relatives in the area. Afridi was ultimately convicted of treason and sentenced to over 20 years in prison. I believe in the need for intelligent surveillance to track foreign terrorist activity. But using the disguise of a public health program for this purpose disrespects the healthcare provider’s philosophy of dutifully serving for the greater humanitarian good.
2. Propaganda against vaccinations, claiming negative health consequences, such as expediting the development of girls and sterilizing boys, and attributing Western vaccination programs to conspiracy plots to eliminate Muslims.
3. Ongoing U.S. drone attacks on Taliban targets in the Waziristan region of Pakistan.
4. General distrust of Western governments and Western medicine.
5. Families’ concerns of deviating from traditional cultural and religious practices.
Ultimately, the film ended on a positive note, highlighting the success of “Justice for Health,” a vaccination program in Peshawar started by Pakistani politician Imran Khan. The importance of health communications is again portrayed in the presentation of this initiative to the public. This project was founded and managed by Pakistani public health advocates and targets nine deadly diseases, including polio. The success of the program can largely be attributed to its establishment as relatively removed from Western influence, despite some assistance from the WHO, and as a comprehensive campaign on multiple diseases. As similar programs continue to prove successful, the role of vaccine diplomacy may be an increasingly feasible mechanism not only to strengthen the world’s health but also to improve international relations.