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Pakistan's Twin Virus: Polio and Terrorism
  • Polio vaccination in Pakistan
    Polio vaccination in Pakistan
On October 27, 2022, unidentified militants killed a paramilitary Levies officer Habib-ur-Rehman, deployed to provide security to an anti-polio team in the Sarki Talari tehsil (revenue unit) of Chaman District in Balochistan. The militants shot Levies Rehman in the head, killing him on the spot. The members of Polio team escaped unhurt.  

On October 25, 2022, a Policeman guarding a polio vaccination team was shot dead by unidentified assailants in the Trat area of Pishin District in Balochistan. Pishin Deputy Commissioner Muhammad Yasir said that the assailants attacked the vaccination team, killing the Policeman, identified as Constable Muhammad Hashim. The polio team workers remained unhurt in the attack. 

On October 24, Pakistan kicked off a seven-day nationwide anti-polio vaccination campaign in an effort to eradicate the crippling disease. The vaccination campaign will be carried out in 28 Districts of Khyber Pakhtunkhwa (KP), 21 Districts of Sindh, 19 Districts of Balochistan and 14 Districts of Punjab.

Whenever a Polio campaign starts in Pakistan, there is violence directed against the vaccination teams. The current Polio programme, the fourth of 2022, had already recorded two incidents, with two Policemen killed. The three previous Polio campaign saw attacks. The first campaign between January 17 and January 24 was, by and large, peaceful, with just one incident of killing of a Policeman on January 25. The second campaign – June 27 to July 3 – claimed three lives, including two policemen and one polio worker. During the third campaign, August 19 to August 29, two Policemen were killed by armed men on August 16 in the Tank District of KP, while escorting a polio team for a survey in the area. 

According to partial data compiled by the South Asia Terrorism Portal (SATP), at least seven Policemen and two Polio workers have been killed in such attacks in the current year (data till October 30, 2022).

The first polio immunisation-linked incident of violence recorded by the SATP database was reported on July 20, 2012, when unidentified terrorists shot dead Doctor Ishaq, associated with the World Health Organization’s (WHO’s) Polio Prevention Campaign, at Al-Asif Square in Junejo Town, Karachi, the provincial capital of Sindh. At least 131 persons (58 health workers and 73 Policemen) have been killed in such violence since then. Another 84 persons (54 health workers and 30 policemen) have been injured in such violence.

In 2012, at least 13 persons (all polio workers) were killed in such attacks. There were 18 [eight polio workers and 10 Security Force (SF) personnel"> such fatalities in 2013; 39 (12 polio workers and 27 SF personnel) in 2014; 12 (six polio workers and six SF personnel) in 2015; 13 (five polio workers and eight SF personnel) in 2016; none in 2017; six (five polio workers and one SF trooper) in 2018; eight (four polio workers and four SF personnel) in 2019; five (three polio workers and two SF personnel) in 2020; and eight (all SF personnel) in 2021.  

Islamist terrorists violently oppose all forms of inoculation, and their resistance grew after the Central Intelligence Agency (CIA) reportedly organised a fake vaccination drive by Doctor Shakil Afridi, to track down Al-Qaeda chief Osama Bin Laden, who was killed at Abbottabad, KP, by US SEALs on the intervening night of May 1-2, 2011. Terrorists and extremists also spread negative propaganda against the vaccination campaigns, including the canard that the vaccination drops were part of a western plot to sterilise Muslims.

The polio vaccination campaign in Pakistan has not only suffered at the hands of terrorists but also due to socio-religious opposition and the issuance of Islamist fatwas (religious edicts). The first such Fatwa came from cleric Maulvi Ibrahim Chisti in the Muzaffargarh District of Punjab on June 12, 2012. Declaring the anti-polio campaign “un-Islamic,” Chisti had warned that a jihad (holy war) would be launched against polio vaccination teams.

Subsequent to Chisti’s ‘divine formulation,’ the then ‘commander of the Tehreek-e-Taliban Pakistan (TTP)’s erstwhile North Waziristan Agency (NWA) ‘chapter,’ Hafiz Gul Bahadur, issued a fatwa on June 18, 2012, denouncing vaccinations as an American ploy to sterilise the Muslim community and banned these in NWA until the CIA stopped its drone strikes in the region. Bahadur’s declaration was a reflection of the consensus reached by the various terrorist outfits that formed the Shura-e-Mujaheddin (Council of Islamic fighters).

On July 31, 2019, TTP warned people against polio vaccination. The one-page message in Urdu seen by people in Miranshah, the headquarters of North Waziristan District, cautioned the public not to allow the administration of polio drops to children or to be ready to ‘face dire consequences’ for their defiance. There were two Polio campaigns immediately after the July threat, in August 2019 and December 2019. A three-day campaign was conducted between August 26 and 28, 2019, during which no one was killed. However, during the five-day campaign conducted between December 16 and 20, 2019, two Policemen deployed for the security of polio teams were killed by unidentified assailants in the Maidan area of Lower Dir city (Lower Dir District) in KP on December 18. Due to the COVID-19 outbreak, all polio campaigns in the country were suspended thereafter.   

After the COVID-19 crisis diminished, as soon as polio campaign was restarted, the attacks by extremists resumed. During the August 2-6, 2021, campaign, three attacks on Polio workers and their security team were reported in which two policemen were killed and another policeman sustained injuries. Similarly, during December 10-13, 2021, campaign, three incidents of attack were reported in which two policemen were killed and another policeman sustained injuries.

The Government, however, claims of having provided ‘fool proof security’ to the vaccination teams. The On June 20, 2022, Pakistan National Coordinator for the Polio programme, Brigadier Doctor Shahzad Baig reiterated, “Every team is escorted by security, by law enforcement agencies, either police [or"> army. And I want to bring it on notice that, so far, the polio program has lost 50 lives in the line of duty to extremist bombings and shootings”. He did not, however, specify the period over which these deaths took place.

People's reluctance to have their children vaccinated due to militant threats has also jeopardised the polio programmes. Quoting Global health security expert Dr. Nadeem Jan, Dawn reported on October 24, 2022, that there was no system of across-the-board accountability in the polio programme. He added, 

Field workers here have been working and putting their life at stake for less than three dollars a day and they are sacked in case of small issues. On the other hand, during last over two decades, high-ups of programme never faced any accountability rather they were transferred or promoted from Pakistan to Geneva or some other country.

Polio remains endemic in just two countries of the world - Afghanistan and Pakistan. According to End Polio Program (EPP), an offshoot of the Federal Health Ministry's Pakistan Polio Eradication Program (PPEP), Pakistan has recorded 20 cases of polio in 2022, so far, and all the cases were detected in the Tribal Areas of KP, bordering Afghanistan. However, the re-emergence of Islamist terrorism in the tribal areas of KP, has created apprehensions concerning the security of Polio administering teams. On August 12, 2022, Federal Minister for Religious Affairs Maulana Abdul Shakoor warned that people of the erstwhile tribal areas would boycott polio vaccination campaign if the government and security institutions failed to restore peace, adding, 

We want to make it clear that if the government and security institutions fail to provide us with peace, the people of [former"> FATA won't accept the measures being taken by the government, on top of which is polio vaccinations.

The extremist Islamist ideologies rampant in Pakistan, substantially supported by state institutions, and the creation of terrorist proxies by the state agencies have produced a deeply radicalized environment in the country, and the irrational opposition to the polio eradication campaign is a direct consequence. This is what has kept the polio virus alive in Pakistan, threatening not only the children of the country, but keeping alive the danger of its resurgence in other parts of the world. Unless poliovirus transmission ends in Pakistan and Afghanistan, all countries remain at risk; equally, as long as extremism and terrorism continue to find fertile ground in Pakistan, the world will remain vulnerable.
Tushar Ranjan Mohanty Research Associate, Institute for Conflict Management