Polio and vaccine diplomacy in Pakistan
This week the global health community is mourning the violent loss of nine workers who were killed while administering vaccines in Pakistan as part of a national polio vaccination program. According to the World Health Organization’s (WHO) global polio eradication initiative, Pakistan is one of three polio-endemic countries worldwide; the other two are Afghanistan and Nigeria. In addition, several other African nations (e.g., Angola, Chad and Democratic Republic of Congo) that were previously certified as polio-free have now been newly re-established. Today Pakistan represents the last remaining source of wild poliovirus type 3 in Asia, with 35 cases in 2012 and three major foci of transmission in the country, including Karachi, Pakistan’s largest city. Because achieving high vaccination coverage rates in Pakistan is absolutely central to meeting global polio eradication targets, the murder of the nine innocent workers who were killed as they went door-to-door providing oral polio vaccines to children is likely to have a chilling effect. This concern is especially relevant for Karachi, where at least five of the workers died and where vaccination efforts have now been suspended. Women comprise most of the health workforce for polio eradication efforts in Pakistan — for the very practical reason that it is easier for a woman to go into a household where other women may be present. There are concerns that women are being singled out, with suspicions that the Taliban may be involved in the killings.