Last week, the Guardian broke the news that in the run-up to the raid on Osama bin Laden’s compound, the CIA used a vaccination campaign as a ruse to get DNA evidence from the al-Qaeda leader’s kids. With help from a Pakistani doctor, Shakil Afridi, they set up clinics in two neighborhoods, delivering doses of the Hepatitis B vaccine to local children. The revelation drew a quick and angry response from health experts. Medecins Sans Frontieres called the operation “a dangerous abuse of medical care.” In the Washington Post, Orin Levine and Laurie Garrett warned that the CIA’s “reckless tactics could have catastrophic consequences.”
Indeed, they may. Here are three reasons why this is bad news for public health:
1. Broken Trust
When people don’t trust medical personnel, they’re less likely to participate in legitimate public health campaigns. Eight years ago, rumors spread that an anti-polio campaign in Nigeria was an American plot to sterilize Muslim girls, causing many families to refuse the vaccine. The subsequent outbreak spread to eight countries. In Pakistan, the CIA’s operation may hurt a efforts to eradicate polio, argue Levine and Garrett:
Many Pakistani communities suffer from preventable infections, including ones that have been brought under control or eradicated elsewhere. Pakistan is the last place on Earth where wild polio still spreads in local outbreaks. Only a handful of places elsewhere in the world have sporadic cases, and vaccine campaigns are vigorous in those areas. But if the Rotary Club, the Bill and Melinda Gates Foundation, governments and others working to eradicate polio realize their aspirations, Pakistan is where victory will be pronounced.
Complicating matters is the fact that Pakistan recently dissolved its Ministry of Health, which has left international programs to negotiate directly with local leaders. Many such leaders may be inclined to distrust doctors or to believe that vaccination programs are CIA ploys designed to hurt their communities.
2. Compromised Security
The CIA’s vaccine ruse bolsters the belief that humanitarian workers are government agents, which may heighten the risk of violence against them. Chris Albon a Ph.D. candidate and the founder of conflicthealth.com, reports that there is a recent history of violence attacks on humanitarian workers in Pakistan and Afghanistan. In 2007, a doctor who spoke out against anti-vaccine propaganda was killed in Bajaur agency. The same year, he notes, Taliban fighters kidnapped a public health worker and held him captive until he promised to stop vaccinating children. Last August, Taliban gunmen captured and killed ten aid workers in Afghanistan, claiming they were spies. Such incidents keep health workers out of high-need conflict zones, often the very areas that are in need of care.
3. Conspiracy Theories, Galore
Humanitarian organizations have spent years trying to convince people that international aid workers are not, in fact, spies, or agents of doom. In Abbottabad and elsewhere, that’s going to be an increasingly tough sell.