How the hunt for bin Laden set back the eradication of polio

1/20/2014

The global campaign to eradicate polio and other preventable childhood diseases was struck a blow when the Taliban renewed its efforts to prevent vaccination in areas of Pakistan under its control and in areas where it persuades people through violence.

In certain parts of Pakistan and Afghanistan and in Nigeria there is widespread belief, perpetuated by the Taliban and certain religious leaders, that Western countries are conspiring to sterilize Muslim children under the guise of vaccination.

These preposterous assertions have been around since 2007. The events leading to the raid that killed Osama bin Laden in the northern Pakistani city of Abbottabad have added credence to those assertions.

What does the hunt for bin Laden have to do with vaccinating children in Pakistan?

The decade-old hunt for bin Laden had led CIA in 2009 to a large house in a spacious compound in Abbottabad. Confirmation of bin Laden and his family living in the house came in bits and pieces. These included satellite imaging, intercepted phone messages from couriers, and surveillance of the compound from a nearby house that was rented by the Central Intelligence Agency.

To further confirm the presence of bin Laden and his family in the house, the CIA needed genetic information on the people living there. For that purpose, the CIA set up a fake vaccination program to administer Hepatitis B vaccine to children in Abbottabad. The program started in poor neighborhoods and moved to a relatively affluent neighborhood where the house under surveillance was located.

The idea was to obtain blood samples from children in the house for DNA analysis. A few health workers were able to get into the well-guarded compound. Whether they were able to obtain any blood samples is not known.

In a daring May, 2011, nighttime raid, Navy SEALs flew from Afghanistan to Abbottabad, entered the compound, and killed bin Laden. His body was flown to Afghanistan and later to a U.S. aircraft carrier for burial in the Arabian Sea.

A few days after the raid, Dr. Shakil Afridi, the physician in charge of the fake vaccination project, was arrested by Pakistani police as he was trying to cross the border into Afghanistan. Accused of treason for collaborating with a foreign spy agency, he was sentenced to 33 years in prison. His conviction was reversed on appeal.

But now he has been charged in the death of a patient who he had treated during his job as a surgeon in the tribal areas of Khyber. The United States is trying to get him released from prison.

The fake vaccination for Hepatitis B has had a terrible effect on all immunization efforts in Pakistan; polio, for example.

Polio is endemic in Nigeria, Afghanistan, and Pakistan. Widespread vaccination and eradication of the virus from endemic areas have been successful to the point that in 2011, there were only 650 cases reported from the three countries, compared to 350,000 cases in 1988.

Polio was within striking distance of being totally eradicated. But not any time soon.

According to Leslie Roberts of Columbia University, as reported in Scientific American magazine recently, the fake vaccination project has set back polio eradication by at least 20 years. In this period, there will be a projected 100,000 more cases. “Forever more people would say,” Dr. Roberts wrote, “this disease, this crippled child, is because the U.S. was so crazy to get Osama bin Laden.”

The fake vaccination also raises ethical questions about Dr. Afridi. He knowingly took part in the scheme and was in part responsible, even if indirectly, for causing death and disability to thousands of children who have gone without vaccination for polio and other childhood diseases.

The reality is that the fake vaccination was not a pivotal link in the identification of the residents of Abbottabad compound. The CIA had pinpointed the location and knew who lived in the house.

Men have, through history, found it convenient to trample on the rights of other people by crossing clearly marked moral and ethical barriers. Unfortunately, the medical profession has been willing to accommodate the wish and whim of those wielding power.

In the preceding century we had the thalidomide tragedy, human radiation experiments, the use of mustard gas, and other incidents.

In comparison, the fake vaccination program was of limited scope. But moral and ethical standards espoused by the medical profession do not allow provisos or qualifiers.

Dr. S. Amjad Hussain is a retired Toledo surgeon whose column appears every other week in The Blade.

Contact him at: aghaji@bex.net