Zeno Swijtink
07-22-2011, 01:51 PM
Science 22 July 2011:
Vol. 333 no. 6041 p. 395
DOI: 10.1126/science.333.6041.395
NEWS & ANALYSIS
PAKISTAN
Decrying CIA Vaccination Sham, Health Workers Brace for Backlash
Sara Reardon
https://www.sciencemag.org/content/333/6041/395/F1.medium.gif
Collateral damage. Fear of conspiracy could prevent Pakistani children from being vaccinated.
CREDIT: MOHAMMAD SAJJAD/AP IMAGES
Each year in Pakistan, 150,000 children die of diseases that are preventable by vaccines. And with its inhospitable terrain, continuing conflict, and widespread suspicion of the West, Pakistan has been a tough place for international health workers to deliver services. Now global health experts worry that the situation may become even more difficult, following a sham vaccination campaign set up in Abbottabad by the U.S. Central Intelligence Agency (CIA). The campaign was a front for an effort to collect DNA from Osama bin Laden's children to verify the family's presence there before Navy SEALS stormed the compound on 1 May.
The Guardian reported on 11 July that the CIA collaborated with a senior government doctor named Shakil Afridi to carry out the ploy. (Afridi is now under arrest for collaborating with foreign agents.) Health workers announced free hepatitis B vaccinations in March and set up a clinic in a poor neighborhood “to make it look more authentic,” according to The Guardian. After delivering the first round of vaccines, the health workers moved the clinic closer to the Bin Laden compound. At one point, nurses entered the compound to administer the vaccinations; The Guardian reported that they may have been instructed to withdraw a small amount of blood after administering the injection, although it's unclear whether they did—or if they succeeded in obtaining DNA. The CIA reportedly wanted to compare the samples with DNA from Bin Laden's sister, who died in Boston in 2010.
The United States has since confirmed the story. “People need to put this into some perspective,” a senior U.S. official said in a prepared press statement. “The vaccination campaign was part of the hunt for the world's top terrorist, and nothing else. This was an actual vaccination campaign conducted by real medical professionals. … And it's not as if this kind of campaign is something the CIA runs every day.”
Still, news of the plot drew protests from international aid groups, including the World Health Organization (WHO), United Nations Children's Fund (UNICEF), and International Committee of the Red Cross (ICRC). “Anything that compromises the perception of neutrality and impartiality of the medical mission undermines the activities of health care personnel, especially in places where access to basic health care is badly needed,” said ICRC spokesperson Michael O'Brien.
Paul Offit, chief of the Division of Infectious Diseases and the director of the Vaccine Education Center at Children's Hospital of Philadelphia, says that the worst aspect of the case is the abuse of disadvantaged people's need for health services. When people are offered free vaccines in countries unable to afford them, he says, “the answer is a resounding ‘Yes!’” Therefore, “to take children who are in need of vaccines … and use that as a front for something else is unconscionable.”
Health leaders fear that the episode will deter Pakistanis and others who hear of the deception from receiving vaccinations and might endanger workers on the ground. In 2007, extremist clerics stoked rumors that polio vaccines were being used to spread AIDS, sterilize Muslims, or otherwise further Western aims. As a result, 24,000 families reportedly refused to vaccinate their children, and some aid workers and clinics were attacked.
As Science went to press, 94,412 vaccination teams were scheduled to administer polio drops to a target population of 33 million children under the age of 5 for National Immunization Day on 18 July. But the Pakistani press reported Monday that health officials “feared large-scale refusals [of the vaccine] from parents in Fata, Waziristan, and several parts of the country, especially Islamabad.”
Officials are taking steps to minimize the damage as news of the CIA ploy spreads. “It has affected our credibility, no doubt about it,” says Sophie Delaunay, executive director of Médecins Sans Frontières (MSF). Already, she says, MSF's field operator in Pakistan has reported that the government is issuing new instructions to foreign health workers on how to conduct their services.
WHO and UNICEF are also working to reestablish public trust. The organizations aim to make sure vaccination teams have proper identification, including ID cards, letters from district authorities, and jackets. They are asking communities to ensure that anyone claiming to be a health worker identify him- or herself. The organizations are working with Pakistani local governments to reassure the public of vaccine safety and the importance of immunization. At the same time, however, says a WHO official close to the developments in Pakistan, the groups “don't want to overreact. As far as impact on health, there are no problems as of now; we're only preparing for that eventuality.”
Delaunay says that the risks extend to the wider medical profession across the globe. She compares the situation to events such as a 2009 case in the Democratic Republic of Congo in which civilians attending free MSF clinics were attacked by the Congolese army. “It almost doesn't matter whether this information was true or not; the fact that the community may think now [that a conspiracy] is possible will undermine our ability to operate.”
She and other health experts say that exploitation of their profession was beyond the pale. “There are rules of the game, even when you are conducting a war,” Delaunay says. “Medical ethics is universal.”
Vol. 333 no. 6041 p. 395
DOI: 10.1126/science.333.6041.395
NEWS & ANALYSIS
PAKISTAN
Decrying CIA Vaccination Sham, Health Workers Brace for Backlash
Sara Reardon
https://www.sciencemag.org/content/333/6041/395/F1.medium.gif
Collateral damage. Fear of conspiracy could prevent Pakistani children from being vaccinated.
CREDIT: MOHAMMAD SAJJAD/AP IMAGES
Each year in Pakistan, 150,000 children die of diseases that are preventable by vaccines. And with its inhospitable terrain, continuing conflict, and widespread suspicion of the West, Pakistan has been a tough place for international health workers to deliver services. Now global health experts worry that the situation may become even more difficult, following a sham vaccination campaign set up in Abbottabad by the U.S. Central Intelligence Agency (CIA). The campaign was a front for an effort to collect DNA from Osama bin Laden's children to verify the family's presence there before Navy SEALS stormed the compound on 1 May.
The Guardian reported on 11 July that the CIA collaborated with a senior government doctor named Shakil Afridi to carry out the ploy. (Afridi is now under arrest for collaborating with foreign agents.) Health workers announced free hepatitis B vaccinations in March and set up a clinic in a poor neighborhood “to make it look more authentic,” according to The Guardian. After delivering the first round of vaccines, the health workers moved the clinic closer to the Bin Laden compound. At one point, nurses entered the compound to administer the vaccinations; The Guardian reported that they may have been instructed to withdraw a small amount of blood after administering the injection, although it's unclear whether they did—or if they succeeded in obtaining DNA. The CIA reportedly wanted to compare the samples with DNA from Bin Laden's sister, who died in Boston in 2010.
The United States has since confirmed the story. “People need to put this into some perspective,” a senior U.S. official said in a prepared press statement. “The vaccination campaign was part of the hunt for the world's top terrorist, and nothing else. This was an actual vaccination campaign conducted by real medical professionals. … And it's not as if this kind of campaign is something the CIA runs every day.”
Still, news of the plot drew protests from international aid groups, including the World Health Organization (WHO), United Nations Children's Fund (UNICEF), and International Committee of the Red Cross (ICRC). “Anything that compromises the perception of neutrality and impartiality of the medical mission undermines the activities of health care personnel, especially in places where access to basic health care is badly needed,” said ICRC spokesperson Michael O'Brien.
Paul Offit, chief of the Division of Infectious Diseases and the director of the Vaccine Education Center at Children's Hospital of Philadelphia, says that the worst aspect of the case is the abuse of disadvantaged people's need for health services. When people are offered free vaccines in countries unable to afford them, he says, “the answer is a resounding ‘Yes!’” Therefore, “to take children who are in need of vaccines … and use that as a front for something else is unconscionable.”
Health leaders fear that the episode will deter Pakistanis and others who hear of the deception from receiving vaccinations and might endanger workers on the ground. In 2007, extremist clerics stoked rumors that polio vaccines were being used to spread AIDS, sterilize Muslims, or otherwise further Western aims. As a result, 24,000 families reportedly refused to vaccinate their children, and some aid workers and clinics were attacked.
As Science went to press, 94,412 vaccination teams were scheduled to administer polio drops to a target population of 33 million children under the age of 5 for National Immunization Day on 18 July. But the Pakistani press reported Monday that health officials “feared large-scale refusals [of the vaccine] from parents in Fata, Waziristan, and several parts of the country, especially Islamabad.”
Officials are taking steps to minimize the damage as news of the CIA ploy spreads. “It has affected our credibility, no doubt about it,” says Sophie Delaunay, executive director of Médecins Sans Frontières (MSF). Already, she says, MSF's field operator in Pakistan has reported that the government is issuing new instructions to foreign health workers on how to conduct their services.
WHO and UNICEF are also working to reestablish public trust. The organizations aim to make sure vaccination teams have proper identification, including ID cards, letters from district authorities, and jackets. They are asking communities to ensure that anyone claiming to be a health worker identify him- or herself. The organizations are working with Pakistani local governments to reassure the public of vaccine safety and the importance of immunization. At the same time, however, says a WHO official close to the developments in Pakistan, the groups “don't want to overreact. As far as impact on health, there are no problems as of now; we're only preparing for that eventuality.”
Delaunay says that the risks extend to the wider medical profession across the globe. She compares the situation to events such as a 2009 case in the Democratic Republic of Congo in which civilians attending free MSF clinics were attacked by the Congolese army. “It almost doesn't matter whether this information was true or not; the fact that the community may think now [that a conspiracy] is possible will undermine our ability to operate.”
She and other health experts say that exploitation of their profession was beyond the pale. “There are rules of the game, even when you are conducting a war,” Delaunay says. “Medical ethics is universal.”