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Explainer: Why Polio Remains Endemic In Afghanistan, Pakistan, And Nigeria

  • Frud Bezhan

Polio-vaccination is risky work in parts of Afghanistan and Pakistan where militants have denounced it as "un-Islamic."

Polio-vaccination is risky work in parts of Afghanistan and Pakistan where militants have denounced it as "un-Islamic."

A global multibillion dollar immunization campaign over the past few decades has made most of the world polio-free. But in Afghanistan, Pakistan, and Nigeria the crippling disease remains endemic.

Despite a coordinated United Nations polio-prevention drive in all three countries, dozens of children become paralyzed and ultimately die from the highly infectious disease every year.

Political unrest, poor health infrastructure, and government negligence are among the reasons for the failure. But the cause analysts cite most often is opposition from religious militant groups.

In all three countries, the most afflicted regions are those where the government's reach is weakest and the presence of Islamic militants is strongest. From the remote, mountainous villages along the Afghanistan-Pakistan border to towns across northern Nigeria, insurgents have kidnapped, beaten, and assassinated vaccinators in a bid to stop local antipolio initiatives.

In justifying their resistance to the polio-prevention campaign, Taliban factions in Afghanistan and Pakistan -- as well as Nigerian militant groups like Boko Haram -- have claimed polio vaccinations are "un-Islamic" and an attempt to thwart the will of God.

'A Western Plot'

In Afghanistan and Pakistan, Taliban factions have also called vaccinations a Western plot to sterilize Muslim populations. Hard-line clerics in Nigeria’s Kano state have issued similar warnings, saying the drugs distributed by the UN were laced with chemicals to make African girls infertile.

Polio vaccines used in the three countries are made in laboratories worldwide, including in the United States, making them a source of resentment for insurgents. Pakistani militant groups like the Tehreek-i-Taliban claim the vaccinations are made out of pig fat or have traces of alcohol, both of which are banned under Islam.
An Afghan health worker (right) administers a polio vaccination to a child on the second day of a vaccination campaign in Laghman province.

An Afghan health worker (right) administers a polio vaccination to a child on the second day of a vaccination campaign in Laghman province.

Some Islamic clerics have even issued fatwas saying that any person who became paralyzed or died from polio would be given the status of a "martyr" for refusing to be duped by a western conspiracy.

Insurgents also claim polio vaccinators are spies.

In Pakistan, such beliefs gained particular credence after it emerged that the CIA used a fake vaccination team headed by a Pakistani doctor, Shakil Afridi, to collect information about Osama bin Laden.

In Pakistan’s North Waziristan tribal area, local Taliban leaders have also issued a fatwa banning polio vaccinations until the United States ceases drone strikes in the area.

Spate Of Violence

In enforcing these bans, militants have killed scores of foreign and local humanitarian aid workers. In the past week, gunmen in Pakistan killed eight polio vaccination workers. In Afghanistan on December 1, gunmen killed a 20-year-old Afghan woman who distributed polio vaccinations in the eastern Kapisa Province.

This spate of violence has coincided with growing cases of polio in Afghanistan and Nigeria -- and threatens to stifle recent progress toward defeating the disease in Pakistan.

In Afghanistan, an polio-prevention campaign involving thousands of volunteers and a number of international agencies almost wiped out the deadly disease in 2010.

The Afghan government registered only 25 polio cases that year, but that figure tripled to 76 last year. Afghan President Hamid Karzai blamed the Taliban, demanding that they allow teams of vaccinators to administer antipolio drops to children in areas under their control.

Meanwhile, the cancellation of the immunization programs in Pakistan on December 19 due to the recent violence threatens to reverse recent gains toward eradicating polio in that country. Some 56 polio paralysis cases where reported in Pakistan this year, down from 190 cases in 2011.

In Nigeria, attempts by Islamic extremists to ban a United Nations immunization campaign have resulted in the infection returning to eight previously polio-free countries in Africa, according to the UN. Last year, Nigeria recorded 43 cases of polio, compared to just 25 cases the year before.
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    Frud Bezhan

    Frud Bezhan covers Afghanistan and the broader South Asia and Middle East region. Send story tips to bezhanf@rferl.org. 

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