by Omar Ali
Polio is an ancient scourge that spreads only within human populations and can cause paralysis, most frequently of the lower extremities, but can also be fatal when the paralysis extends to the muscles of breathing. For reasons that are not completely clear, the disease erupted in huge epidemics from the late 19th century onwards, causing millions of victims to die or become paralyzed for life. Once a virus had been identified as the cause, the race was on to develop a vaccine. Finally, in 1952, Jonas Salk and his colleagues developed the first effective inactivated vaccine for this disease. Within a few years, mass vaccination decreased the number of victims in developed countries from hundreds of thousands to just a few hundred per year. In the mid-fifties, Albert Sabin and colleagues developed an effective live vaccine that was cheaper, easier to adminster and provided better immunity and that was then adopted by the WHO as the main vaccine for use in endemic areas. Thanks to mass immunization campaigns, the number of victims dropped precipitously and by 1988 the WHO was ready to launch a well-coordinated international initiative to completely wipe out wild polio from the planet. Like smallpox, polio does not have an animal reservoir, so if human to human transmission is completely blocked by mass vaccination the disease can be effectively wiped out.
Initially, the campaign proceeded well, with the Americas being declared polio-free in 1994 and Europe in 2002. Today, there are only 3 countries where polio still remains endemic: Pakistan, Afghanistan and Nigeria. Unfortunately, the reason in all three is the same; the moronic wing of the international Jihadist movement has somehow picked up bits and pieces of chatter about risks from oral polio vaccine, combined it with pre-existing paranoia about modern international institutions, and created a robust anti-vaccine meme that is able to draw upon the ruthless killing power of Jihadi militias to effectively stop polio eradication campaigns in their area of influence.
I would like to clarify this a bit further:
the medical literature includes many scholarly papers about the possible reasons for vaccine resistance in different communities. Many of these reasons have nothing to do with Jihadism. In some cases, the community has no experience of modern medical care and has never seen government employees going door to door and giving something good away for free. There is extensive (and frequently, not unfounded) mistrust of foreigners and government workers. Sometimes the issue can become entangled in local politics (e.g. mistrust between the Nigerian federal government and the state governors in the Muslim North, or even the question of who has authority to conduct a campaign in such and such area). Then there are the technical and administrative hurdles in the way of establishing a “cold-chain” (keeping the vaccine refrigerated) and effectively reaching remote areas, and so on. But the WHO has long experience of dealing with such issues. They are not “Muslim-specific” issues and their solutions are also not Muslim-specific. Local governors may need to be sweet talked, community representatives may need to be invited on to committees and councils, religious leaders and others may need to be brought on board; all this is standard and has been tried. It has worked in places as lawless and anarchic as the Congo and as impoverished as Mozambique. What makes the situation in Pakistan and Nigeria unique is not these (“morally neutral”) factors, but the added factor of Jihadist intimidation and terrorism. Without that last factor, there is absolutely no reason why the residents of FATA cannot be immunized in the same way the poor Muslims of North India or Indonesia have been immunized (in spite of fatwas against vaccines by nutcase mullahs in those countries as well). There may be some initial resistance and some special steps may need to be taken, but the task is very much doable (and has been done in many African areas that are at least as poor and remote as FATA and Northern Nigeria, and in some that are far more so). Neither is the existence of a tiny fringe of anti-vaccine activists sufficient to jeopardize this campaign. The campaigns can (and clearly HAVE) worked in the poorest and most inaccessible countries and can work in spite of fringe opposition, as long as the opposition is not armed and dangerous. This is important to keep in mind.
How and why these Jihadist organizations became infected with this meme is still unclear. My own hunch is that it was simply a matter of ideal host meets appropriate parasite; Islamists in general thrive on conspiracy theories and a paranoid anti-modern worldview (the elders of Zion being the best known, but hardly the only example). As one moves to the fringes of the movement, the educational level declines, the scientific ignorance increases and the paranoia reaches incredible heights (I urge all readers who are suppressing an urge to jump in and say “but the paranoia is not without foundation” to please suppress that urge a little longer, I will get to that). Some mullah reads somewhere that X or Y Western anti-vaccine crusader has written about the possible effects of vaccine contaminants. Already convinced that Western powers and their evil agents in Muslim countries are working day and night to wipe out the Muslim Ummah, it is not hard to imagine that the oral polio vaccine may itself be a weapon in that war. Since both male impotence and vaccinations are commonplace, the connection is easily proven to the satisfaction of all concerned. Anti-vaccine propaganda thus became embedded in the fringes of the Jihadi world and as civil wars accelerated in Nigeria, Afghanistan and Pakistan, so did the attacks on polio teams.
It is worth noting that this meme did NOT start with Dr Shakil Afridi’s CIA-sponsored fake hepatitis vaccination jig in Abbottabad (meant to try and obtain DNA from the Bin-Laden family). Major problems had arisen in Northern Nigeria as far back as 2003 and in Pakistan by 2007.
The governments of Nigeria and Pakistan made extensive efforts to try and convince resistant populations to permit vaccination. Major religious figures thought to be respected by the Jihadists (Sheikh Qardawi in Nigeria, Maulana Samiulhaqin Pakistan) have been roped in to try and show that the vaccine is not a plot against Islam. Some effort has been made to tell people that “Islamic” countries like Saudi Arabia and Malaysia immunize their populations and do not regard the vaccine as an imperialist plot, but to no avail. The insane fringe of the Jihadist movement is too far gone by now to be convinced in this manner. In any case, the Pakistani state has itself long encouraged anti-Western and especially anti-Jewish memes as tools to mobilize irregular forces for various foreign policy adventures (and some Muslim politicians in Northern Nigeria have likely done the same in their ongoing competition with Christian Nigerians). These memes have taken firm root in the network of “scholars”, journalists and other opinion leaders who provide intellectual leadership to the Jihadist cause. Paranoia about polio vaccine fits in smoothly with the rest of this intellectual complex and is proving extremely difficult to overcome even where pro-Jihadi mainstream politicians like Imran Khan have taken the lead and tried to convince the jihadists that this particular Jewish invention (both Sabin and Salk happen to have been Jews) is kosher, so to speak.
As an example of how the meme operates, take a look at the good folks at Ummat newspaper in Karachi, who published a “research article” back in December 2012 that provided “scientific evidence” of the threat from polio vaccine. This newspaper is affiliated with the most literate and modern Islamists in Pakistan, i.e. the Jamat e Islami old guard from Karachi. These are the kind of people whom postcolonial scholars sometimes regard as a secularizing force in Pakistan (I understand that her argument in the piece linked above is relatively sophisticated, but I think it’s still wishful thinking; Like many liberal Muslims she too has difficulty accepting how committed even modern Islamists are to the medieval texts and fascist dreams of their less sophisticated Jihadist friends). Anyway, on a day when 8 polio campaign workers (mostly women) were killed in 4 different cities for trying to immunize kids against polio, this modern Islamist newspaper published a major feature article full of ignorant paranoid claptrap about the dangers of polio vaccine.
For those who cannot read Urdu, the headline says: Monkey cells are used to prepare polio vaccine
This is followed by the following main points:
1. In 2006 Mr. Mohammed Nabi filed a petition in the Peshawar high court asking for a ban on polio vaccine because it contained female hormones.
2. in 2004 there was a campaign in Nigeria against the same vaccine and Nigerian scientists determined (via testing in India) that the vaccine was “harmful to the reproductive system”.
3. Ummat has conducted its own investigation on the internet and determined that the vaccine indeed contains female hormones and is made using monkey cells (the last part is true, and led to some SV40 virus contamination in the early years of polio vaccine but there is no conclusive evidence for harm from that contamination).
4. Before 1950 polio was mostly prevalent in Europe and America (the hint here is that we may be victims of a plot that is spreading this new disease to us, and then using this as an excuse to load us up with killer vaccine).
5. Polio vaccine can cause paralysis (this is true, but extremely rare and the risk from wild polio is MUCH higher).
6. Oral polio vaccine is banned Europe and America but continues to be used in third world countries. (it’s true that since the only 3-4 cases of polio that were occurring in the US were due to vaccine virus, wild type polio having been wiped out USING THE VACCINE, therefore it made sense to switch entirely to the more expensive and less immunogenic, but safer, injectable vaccine. The situation is completely different in endemic regions and the risk-benefit ratio is very much in favor of oral polio vaccine in those areas).
7. In India the vaccine drive has led to a 1200% increase in paralytic polio (I am not sure what this claim is supposed to mean. India was declared polio-free this year so the claim makes no sense).
The point of citing this article in detail is to show that Ummat is feeding anti-polio vaccine hysteria (especially with its baseless claims about female hormones and danger to reproductive health) just as their Taliban brothers are shooting innocent female health workers trying to immunize children who are at risk. And neither is claiming Dr Afridi’s CIA campaign as their main objection to this vaccine.
In the last few weeks alone, jihadist terrorists have attacked several polio teams, killed male and female polio workers, and kidnapped teachers who took part in the polio campaign. The courage of the health workers who continue to operate under these conditions and the absolute evil of those who target them are both exemplary. But it is very difficult to see how polio eradication can proceed under these circumstances. In fact, I think it’s a safe prediction that we (as in humanity) will not be able to eliminate wild polio in the foreseeable future because of the efforts of these few determined enemies of infertility and impotence. Already we have seen outbreaks in China and Syria that have both been traced to Pakistan (and it is likely that in both cases the vector was Jihadists travelling from Waziristan to China and Syria for holy war) and if current trends continue, we may see wild polio reappear in countries like India and Indonesia from which it was recently wiped out after great effort.
Unfortunately, people who happily kill innocent teachers and health workers and are directly responsible for the paralysis and death of hundreds of children (with many more to come) sometimes get more sympathy from Western anti-imperialists and anti-globalization activists than their victims. In fact, these activists provide the killers with new and better justifications via the internet (ironically, another feature of globalization). There is a very powerful strain of racism and paternalism hidden in this form of “understanding and empathy”. These same activists clearly do not expect their own population to cut off their nose to spite the face. Even if the state occasionally uses health or educational institutions to spy on people (as it clearly has in the past), Carol Grayson and her friends do not expect Welshmen and West Virginians to shoot public health workers and teachers as a result. But since they seem to regard Nigerians and Pakistanis as especially retarded and simple-minded (unspoilt and innocent, but also unsophisticated), they find it perfectly reasonable for them to go around doing the same. The fact is no CIA or Mossad operation and no unethical drug trial is sufficient excuse for killing innocent health workers trying to stop a lethal disease. If people are doing so, they need to be told that it is not acceptable to do so, instead of using every atrocity as another opportunity to attack imperialism, capitalism or whatever ideological current you hold responsible for the state of the world as a whole.
I realize that the above paragraph is not philosophically air-tight. If capitalism is indeed the cause of all evil, then everyone who is gumming up the onward march of international capitalism is, by definition, a good guy. But my contention is that Western activists (and their Westoxicated Eastern admirers) do not really believe in any such absolute clash of good and evil and would not really want to live in the pre-industrial utopia of the Taliban. They only find it easy to admire heartless killers when faraway people are being discussed. I realize that I cannot stop this huge anti-capitalist cultural force with one article, but I just wish they would stay off the topic of polio vaccination. Humanity is tantalizingly close to wiping out this menace. It would be a shame to fail now just to make a point about the CIA or capitalism or American imperialism.