Health has been praised as the most successful sector of the development field, with its easy measurability, its poignant visibility, its attainable fix in the form of vaccination and, notably, its removed place from the messiness of politics, at least in comparison to economic or education policy. However, as the Global Polio Eradication Initiative (GPEI) at last approaches its noble goal of a polio-free world, political unrest and fervor is increasingly thwarting and complicating vaccination efforts in Pakistan. Clearly, the choice to use polio as a political tool is unethical, but the politicization of the fight against polio also seems inevitable when polio eradication exists as a pet project of the United States.
Notably, the GPEI has an inherently American flair. Consider its four founders: WHO, Rotary International, the US Centers for Disease Control and Prevention (CDC), and the United Nations Children’s Fund (UNICEF). Rotary and CDC have specific ties to American interests; CDC is an American institution and Rotary was founded in the United States. In general, the United States struggles to differentiate political agenda and humanitarianism. Examples of this can be found in the frequent criticism of foreign aid’s centralization in the State Department rather than USAID, or the preference of U.S. allies as aid recipients. Despite its description as “global,” polio eradication has a decidedly American kinship, birthed and nourished by U.S. donors and abused by political leaders on both sides. However, polio eradication is labeled not “American,” but “global,” and the initiative must start to reflect this distinction.
The goal of polio eradication has become increasingly intertwined with U.S. political interests. In 2011, news burst that the CIA had used a fake polio vaccination team to gain access to the Bin Laden compound in order to collect information. Given that the United States and Pakistan wrestle with such a uniquely strained relationship, this act was detrimental to relations between American humanitarians and the Pakistani people. The repercussions of this mission have been drastic, with a marked increase in polio violence since the leak. Furthermore, Taliban leaders have banned polio vaccinations in certain regions as a protest against U.S. drone strikes. Polio has descended from its humanitarian sacredness to the dredges of political violence, and we have been the ones pulling it down.
This January, as the GPEI geared up to celebrate the declaration of India as polio free, three polio vaccination workers were killed in a shooting in Peshawar, the latest in a series of violent acts toward polio vaccination teams. Perhaps the fault lies with the American approach to polio vaccination and humanitarian efforts in general, not just Pakistani extremists.
This instance of violence is among several others that indicate mounting hostility toward the GPEI—a hostility that initially seems nonsensical given the initiative’s humanitarian mission. Health workers in Pakistan, one of three countries where polio remains endemic, are struggling to realize the goal of a polio-free world amidst resistance to vaccination and mounting violence against vaccination workers. The stakes for polio in Pakistan are high for the GPEI’s ultimate goal of eradication: progress in Afghanistan will be nearly impossible due to migration if polio in Pakistan remains endemic. Not only do vaccinators struggle with the conventional difficulties of vaccination (resources, lack of visible positive outcome, etc.), but now they also must combat recent rumors of vaccination as a tool to secretly sterilize Muslim children.
Polio eradication’s situation as a project funded principally by American donors, organized by American institutions, and used to the advantage of American interests is currently paralyzing vaccination efforts. While the efforts by U.S. citizens and government organizations are noble, they are American efforts and foremost American efforts; therein lies the problem. Politicization of polio is perhaps symptomatic of the fact that polio eradication is an innately American effort. The consequential political violence is rendering the fight against polio asymptotical, and is even resulting in polio cases cropping up in formerly polio-free Syria. Globalizing the polio eradication effort is essential to the de-politicization of the initiative and the ultimate goal of a polio-free world.