Editor in Chief: Moh. Reza Huwaida Thursday, February 25th, 2021

Anti-Polio Campaign and Impediments to It

Afghanistan is one of the countries where polio remains endemic. The number of reported cases had been reduced in recent years in the wake of campaign against poliovirus. But as mounting insecurity hampered the campaign, the cases have been moving upward.
Reports show that the cases of polio in Afghanistan dropped from 80 in 2011 to 37 in 2012. The downward trend continued with 8 cases confirmed, in eastern part of the country, during January – September 2013, compared with 26 within the same period in 2012. In 2016, 13 polio cases were registered, down from 20 the year before and 28 in 2014. In 2015, in which polio reduced to a great extent, 40 per cent of cases were reported from Nangarhar province in eastern Afghanistan, which borders Pakistan. In 2017, the total number of officially reported wild poliovirus type 1 (WPV1) cases in the country was 14.
But in 2020, total polio positive cases reached 56, according to Ministry of Public Health (MoPH), as the COVID-19 spread delayed polio vaccination campaign for six months and 3.4 million children were deprived of the vaccine across the country. This year, no polio cases have been reported so far.
The spread of coronavirus pandemic and mounting insurgency have disrupted the anti-polio campaign. It is believed that two main obstacles hamper the campaign in the country. First, a sense of mistrust filled the air in tribal belts – where the militants hold strong sway – as a result of the militants’ negative propaganda. Parents lost their trust in health workers and showed little tendency in having their children vaccinated. Second, the escalated insurgency in restive provinces jeopardize the life of health workers. Warring factions, mainly the Taliban, spill the blood of combatants and non-combatants indiscriminately. They have constantly violated humanitarian law through slaying women, children and health workers. In other words, although medical facilities, staff and patients during war time are given immunity by the Laws of Armed Conflict – also known as International Humanitarian Law – the militants target them on purpose. Within past years, a number of polio workers, including women, have been targeted by armed gunmen in insecure provinces.
Three reasons are believed to be behind the militants’ opposition to the administration of oral polio vaccine (OPV) to kids. First, the fake vaccination scheme, which was used as a cover to track the whereabouts of Osama bin Laden in 2011, triggered a sense of mistrust and hatred among the terrorist networks. Second, they deem the anti-polio campaigns a ploy by the US policy-makers rendering recipients impotent or infertile so as to reduce the Muslim population and the Taliban call it even against Islam. Third reason is vis-à-vis female workers. The militants’ attacks against female health workers might be mainly the result of their misogynistic view and their mindset denying women’s social role and discriminating them on the ground of their sex. 
Health workers are threatened not only by terrorist groups but also by counter insurgency war. For instance, dozens of health workers and patients were killed in October 2015 as a result of the US military air attack on the Kunduz Trauma Center. Similarly, eight polio workers were killed while performing their duty in 2014. War is a serious threat to health workers and impedes their operations in this regard.
Thanks to clerics for mitigating this problem through issuing decree in support of anti-polio campaign and endorsing polio vaccines. In 2016, a National Islamic Advisory Group for Polio Eradication was founded to bridge the gap between parents and health workers which was brought about by the militant fighters. Consequently, almost 90 per cent of Afghans accepted how critical immunization was for their children and the improvement paved the ground for the implementation of 2016 polio-free in 99 per cent of Afghanistan’s districts.
Constitutionally, the state is committed to “provide free preventative healthcare and treatment of diseases as well as medical facilities to all citizens in accordance with the provisions of the law.” I believe that the Afghan government will not be able to eradicate diseases, especially the polio, without international aids. No wonder, World Health Organization (WHO) and UNICEF play key role in the campaign against polio. Four decades of war has inflicted great harm on Afghanistan’ political structure and economic infrastructures. That is to say, terrorism is still a challenging issue for the government and it has caused severe blow to the country’s economic bases. Therefore, the country will not be able to continue this campaign without international supports.
MoPH said that a nationwide anti-polio campaign was launched this week in cooperation with UNICEF and WHO, targeting 9.9 million children below five years of age. It assured that the vaccine was secure and had been approved by religious scholars at national and international level. It is the government’s responsibility to protect the life and liberty of all, especially health workers, so that the anti-polio campaign can bear the desired result. If militancy continues unabated and health workers lose their lives, Afghans will not have a polio-free country in near future.
Now the question is that why Pakistan and Afghanistan remain in the list of polio epidemics out of 123 countries despite the global campaigns against polio within more than two decades? It is most likely that terrorism is the only impediment to the anti-polio campaign. In short, the Taliban in Pakistan and Afghanistan spread misconception and target health workers.
Clerics and health workers fulfilled their duties in the best possible way. The clergy persuaded parents to have their children vaccinated so as to safeguard them against disabilities and erased misconceptions spread by the Taliban to a great extent. Health workers made great sacrifices to immunize children in any parts of the country. The only obstacle in this respect seems to be the escalated militancy. To have a polio-free Afghanistan, the state will have to provide a safe ground for health workers and make sure that every single child is vaccinated against polio. Moreover, the Taliban have to respect national and international law and allow health workers to continue the anti-polio campaign and parents to have their children vaccinated.