Pakistan

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September 26, 2011 | 12:08 PM | By

Polio spreading from Pakistan to China

UNICEF

Child receiving oral polio vaccine

This is a discouraging reminder that global health is truly global, especially when it comes to infectious disease.

As NPR’s Joe Neel reports today, Pakistan’s failure to eliminate polio appears to have spilled over into China and threatens to spread even wider. Neel reports:

The World Health Organization says the rates of polio in Pakistan have caused it to rate as “high” the risk of further international spread of the wild poliovirus from Pakistan …  there is particular concern with large population movements around the Hajj pilgrimage to Mecca in Saudi Arabia, Nov. 4-9.

Here are some other similar reports from Inter Press and the Washington Post, noting that this strain of the virus is more dangerous in that it is more easily spread.

The Economist says a “surge against polio” is needed now if the long-sought goal of polio eradication is to be achieved. A week or so ago, the Bill & Melinda Gates Foundation put out this video urging the international community to finish the job and eradicate polio:

Why is polio so especially difficult to control in Pakistan?

Poverty and lack of adequate health services are two reasons. But much poorer countries have succeeded in ridding themselves of this disabling and once rampant disease.

Conflict in Pakistan is also part of the problem. It’s difficult territory for humanitarian organizations. And foreign health campaigns may be especially mistrusted these days — given the U.S. and the West’s already strained relationship with Pakistan and this unfortunate CIA “fake vaccination” ploy done there a while ago.

FILED UNDER: Health, Bill & Melinda Gates Foundation, Pakistan, polio, vaccines
August 9, 2011 | 11:00 AM | By

How the rush to help can thwart best intentions of foreign aid

Despite the best intentions, foreign aid often goes awry in countries overwhelmed by war.

Jack Healy, writing in Monday’s New York Times, offered a vivid, and depressing, example of governments rushing in to help people without carefully weighing all of the issues, in his story of the small village of Alice-Ghan in Afghanistan.

“ALICE-GHAN, Afghanistan — This tiny village rose from the rocky soil with great hopes and $10 million in foreign aid, a Levittown of identical mud-walled houses built to shelter some of the hundreds of thousands of Afghans set adrift by war and flight.

“Five years later, the village of Alice-Ghan and those good intentions are tilting toward ruin. Most of its 1,100 houses have been abandoned to vandals and the lashing winds. With few services or jobs within reach, hundreds of residents have moved away — sometimes even to the slums and temporary shelters they had sought to escape…

“The settlement, a little more than an hour’s drive north of the capital, Kabul, on the border with Parwan Province, is one of 60 scattered across the country. It has become a demonstration of the miscalculations and obstacles that have thwarted so many similar efforts to tackle huge problems like poverty, hunger, illness and dislocation in Afghanistan. “

Wikimedia Commons photo

The tents of displaced Afghans still dot the countryside.

The problems facing the U.S., Australian and Afghan government attempts in Alice-Ghan include a lack of basic services like electricity and running water, cultural misunderstandings and corruption.

These problems are similar to those elsewhere, like in Iraq, which resulted in the loss of millions, if not billions, of dollars and contributed to the enormous suffering of people there and also helped drive at least 2 million Iraqis out of the country.

Michael Shank, writing in The Guardian last month, summed up the problem with corruption and other misguided efforts regarding foreign aid rather well: Continue reading →

FILED UNDER: Politics, Afghanistan, foreign aid, Iraq, Pakistan
July 14, 2011 | 1:22 PM | By

Three reasons why CIA faked vaccines may cause contagion of damage

Flickr, johanoomen

New Action Thriller: From UNICEF with Love?

Now that the CIA has acknowledged running a deceptive, if not totally fake, vaccination program in Pakistan as part of the effort months ago to hunt down Osama bin Laden, here are three reasons why this episode is prompting an angry response by those who work against global poverty and disease:

  1. This isn’t just about vaccines — about fighting terrorism vs fighting polio.
  2. Health workers and aid workers overseas have to be seen as neutral and independent if they are to operate effectively and safely.
  3. National security isn’t achieved just by hunting and killing bad guys. It’s also achieved through humanitarian efforts, aid efforts and other forms of international collaboration based on mutual trust.

So let’s review where we are so far with the strange case of “The Immunizer of Abbottabad.”

After The Guardian on Monday first revealed this bizarre scheme aimed at collecting DNA from bin Laden family members, the CIA apparently has confirmed to the Washington Post that it did set up the vaccination program in northern Pakistan. Here’s what some anonymous official reportedly told the newspaper:

A senior U.S. official said the vaccine campaign was conducted by medical professionals and should not be construed as a “fake public health effort.”

“People need to put this into some perspective,” said the official, speaking on condition of anonymity because of the sensitivity of the issue. “The vaccination campaign was part of the hunt for the world’s top terrorist, and nothing else.”

“If the United States hadn’t shown this kind of creativity, people would be scratching their heads asking why it hadn’t used all tools at its disposal to find bin Laden.”

Actually, many seem to be scratching their heads asking how the Central Intelligence Agency (given its middle name) came up with such a far-fetched scheme — it doesn’t appear to have worked — and how it can argue with a straight face that this was, in addition to a covert op, a legitimate vaccination program.

To begin with, just giving kids a real Hepatitis B vaccine doesn’t mean it’s not fake public health. Continue reading →

FILED UNDER: Health, Politics, Alanna Shaikh, CIA, James Fallows, national security, Osama Bin Laden, Pakistan, Sarah Boseley, The Guardian, vaccines
July 12, 2011 | 11:03 AM | By

Did CIA undermine global health by faking vaccines in hunt for Bin Laden?

by hitthatswitch, Flickr

One of the chronic problems the international community has with almost every disease-fighting campaign has been the need to overcome mistrust — mistrust of government, of foreign health workers or outsider do-gooders in general.

This is, for a variety of reasons, especially true of vaccines.

So many worry that such global health efforts will suffer from the revelation, reported first in The Guardian and later by the New York Times and others, that the Central Intelligence Agency (CIA) set up a fake vaccination program in Pakistan in order to collect DNA samples. Says The Guardian:

The CIA organised a fake vaccination program in the town where it believed Osama bin Laden was hiding in an elaborate attempt to obtain DNA from the fugitive al-Qaida leader’s family, a Guardian investigation has found.

The CIA has refused to confirm or deny these reports.

Most of the media reports tend to focus on issues of terrorism, foreign policy and the increasingly strained relationship between the U.S. and Pakistan. There was little attention, initially anyway, given to the possibility that this CIA ruse could also seriously undermine a key tool in the worldwide battle against disease. Continue reading →

FILED UNDER: Health, Politics, Brett Keller, Chris Albon, CIA, Pakistan, polio, vaccination
May 3, 2011 | 9:50 AM | By

With Bin Laden’s death, foreign aid to Pakistan under the microscope

Flickr, k-ideas

Now that Osama Bin Laden is dead, many are taking a hard look at the massive U.S. program of foreign aid to Pakistan – about $3 billion a year, half of that to pay them for helping us fight terrorism.

I hope they’ll take a hard look not just at what we’re getting for the money but why we give it.

What exactly are we trying do with what we call foreign aid?

We actually give very little, per capita and compared to most wealthy nations. And we seem to be giving it mostly for political reasons.

When Egypt erupted in popular protest against dictatorship, many Americans (including, apparently some members of Congress!) were surprised to learn that Egypt was the second or third largest recipient of U.S. foreign aid — and that most of that “aid” went to buy military supplies. Continue reading →

FILED UNDER: Politics, foreign aid, foreign policy, global health, Obama Administration, Osama Bin Laden, Pakistan
March 11, 2011 | 3:39 PM | By

Disaster in Japan … and Haiti, Pakistan, Congo, Ivory Coast, Niger, Mali

Flickr, doegox

We are all focused on the disaster in Japan right now, as we should be.

But what about the other, bigger disasters?

The massive earthquake, tsunami and current concern about damage to a Japanese nuclear power plant are the top news stories today. The quake was huge, the fifth largest in the last century. President Obama said today the U.S. is “marshaling forces” to help Japan deal with the catastrophe.

Local relief organizations like World Vision and Mercy Corps have put the Japanese quake-tsunami on the “front page” of their websites even though it is unlikely either organization will be doing much in response. I talked to both organizations and they are standing by ready to help, but both said it is possible they will not be needed.

Japan can largely take care of itself. World Vision and Mercy Corps take care of those who can’t. Continue reading →

FILED UNDER: Congo, disaster, earthquake, Haiti, Ivory Coast, Japan, Mali, Mercy Corps, Niger, Pakistan, tsunami, World Vision
October 26, 2010 | 4:49 PM | By

Boost to polio campaign

UNICEF

Child receiving oral polio vaccine

A new vaccine against polio is being touted as the boost needed to finally achieve eradication.

The vaccine known as bOPV (for bivalent oral polio vaccine), was tested against the current vaccine in India — where polio stubbornly persists — and found by researchers to be about 30-40 percent more effective in preventing infection by two main strains of the polio virus. The study was reported Tuesday in The Lancet.

Meanwhile, the World Health Organization announced it will launch a major new vaccination campaign across Africa. Since the global campaign to eradicate polio was launched in 1988, with major assistance from Rotary International and more recently from the Bill & Melinda Gates Foundation, polio cases worldwide have been reduced by 99 percent.

Polio remains endemic in four countries — India, Afghanistan, Pakistan and Nigeria — but if not eradicated could easily spread again into other countries and perhaps worldwide. Funding for the polio campaign remains another hurdle as donors have so far only funded about half of what’s been estimated as needed to complete the campaign as part of the global vaccination initiative.

Also in polio news today, though it shouldn’t have been, were various stories that reported Ted Turner announced in Nigeria plans to donate anywhere from $80 million to $1 billion to the polio campaign.

Turned out it wasn’t true.

FILED UNDER: Health, Afghanistan, Bill & Melinda Gates Foundation, India, Nigeria, Pakistan, polio, Rotary International, World Health Organization
October 21, 2010 | 9:00 AM | By

USAID Branding: Pressure still on to end the dangerous desire for self-promotion

It may be off the headlines now, but the pressure remains on USAID from many prominent NGOs like World Vision, Oxfam and Save the Children to end its requirement of putting the American flag on donated materials.

I wrote about this dispute last week and a USAID official told me talks aimed at resolving this disagreement are “intense.”

Humanitarian groups say they need to remain — and appear — politically neutral. They also don’t like getting killed just for PR purposes. Continue reading →

FILED UNDER: Politics, Afghanistan, Oxfam, Pakistan, Save the Children, USAID, World Vision