Not just a Scientific Problem: Polio eradication in Pakistan

Pakistan's health ministry released a video last month of a father pleading with viewers to vaccinate their children against polio. Pakistan is one of only two countries in the world where poliovirus is still endemic. Though the country has made enormous strides towards polio eradication, from having 20,000 cases in 1994 to only 12 cases in 2018, there has been a renewed wave of mistrust and refusal to vaccinate children in recent months. Four new cases of polio have been confirmed since January 1, and the virus has been identified in the sewer water of 8 urban centers across the country. This setback is not a result of lack of resources or crumbling infrastructure: Pakistan has enough international support to vaccinate every child in the country twelve times over. The trouble is deep mistrust between the people and the government. Widespread rumors claim that the polio vaccine is an antifertility drug meant to prevent Pakistani people from having children. Others claimed they were poison sent from America because of anti-muslim sentiment. In some areas, militant anti-vaxxers have committed violence against public health workers administering the vaccine. In the last six months, a video of unknown origin went viral, describing the polio vaccine as a menace to the health of Pakistani children.
This situation is another example of the complex factors that mediate viral disease. Understanding the virus and its impact on the host alone is not enough to effectively combat viral infections and promote human health. This case reminds me of the public response to calls for yellow fever vaccination in Brasil during the outbreak about a year and a half ago: deep mistrust between the public and the government allowed lies about the vaccine's safety to spread. One of the biggest challenges, in Brasil and Pakistan, is that mistrust of the government is not unfounded-- in order to effectively promote health, the governments of these countries must rebuild the faith of the people in their ability to govern in a trustworthy manner. Combatting polio in Pakistan, and infectious disease everywhere is not only a biological and ecological challenge, but a deeply political one.

Sources:

• https://www.washingtonpost.com/world/asia_pacific/pakistan-on-verge-of-eradicating-polio-virus-faces-human-hurdles/2019/03/04/8758b01c-353d-11e9-8375-e3dcf6b68558_story.html?noredirect=on&utm_term=.00452b20ef58
• https://www.washingtonpost.com/video/world/father-of-polio-victim-in-pakistan-appeals-for-vaccination/2019/03/05/b66b2f5e-56d3-416f-b893-3e6536f2ed9-c_video.html?utm_term=.bfa512ee9c84
• https://www.who.int/csr/don/11-february-2019-yellow-fever-brazil/en/

~Lisa Manzanete