In the new millennium, polio has become a prominent disease within global health discourse, particularly with regards to the Millennium Development Goals. Amelia Worley provides a historical, social and geopolitical perspective on the fight to end polio.
Polio today has become synonymous with severe poverty, instability and conflict. The presence of polio can be considered a product of historical, social and economic processes. The quest to eradicate polio by the Global Polio Eradication Initiative (GPEI) over the past few decades has become a controversial endeavour. Undoubtedly, the GPEI has significantly reduced the number of polio outbreaks globally. However, as billions and billions of dollars continue to be invested, it begs the question as to why there remains such a dearth of investment in long-lasting primary healthcare systems.
The GPEI’s mission became intensely political in 2003 when groups in Kano (Northern Nigeria) initiated a boycott against the polio vaccine, claiming it contained anti-fertility agents and the HIV/AIDs virus. The claims were backed by the Supreme Council for Sharia in Nigeria, who warned the vaccines were a being used as a tool by Americans to wipe out Muslim communities. The boycott emerged during a time of unstable relations between the USA and Muslim regions, and the revelation of a fake vaccination campaign carried out by the CIA in 2010 as part of their mission to locate Osama Bin Laden further increased the vulnerability of vaccination teams in their ability to stand independently from geopolitics.
The GPEI initiative has been tainted irreversibly by wider international conflict and politics and as a result, polio vaccinators are now a major target for the Boko Haram in Nigeria and the Taliban in Pakistan. Given the heightened vulnerability of polio teams in Northern Nigeria to terrorist attack, the ethics of completing the eradication of polio has become infinitely more complex.
Can and should polio eradication be maintained as a priority over issues of security?
Regardless of geopolitics, Kano’s colonial heritage, modern history and healthcare infrastructure curated an environment in which the rumours about the vaccines were able to thrive. In 1996, the multinational pharmaceutical giant Pfizer conducted unethical clinical trials for the meningitis drug Trovan in the Kano area, which resulted in the deaths of 11 Nigerian children. It took 15 years before Pfizer faced the justice system. These incidents, coupled with the tainted imageries of the GPEI team, leave little ground for trust attitudes towards ‘unknown’ drugs.
The Question of ‘Glory’
William Muraskin argues that the West are committed to eradicating polio because of the ‘glory’ success would bring. Polio was perhaps chosen as a focus due to the flawed belief that it would be relatively easy to eradicate after similar success with the smallpox vaccine.
The channelling of expenditure and effort into one specific vaccine meant Nigeria failed to build on the capacity and effectiveness of necessary, basic health institutions. Furthermore, the polio-focused funding provided by the GPEI failed to recognise the inequality and pervading disparity between health outcomes that should have been addressed and recognised prior to the imposition of top-down campaigns. Building effective primary healthcare systems is long and arduous, and unlikely to fulfil any elements of ‘glory’, but is essential for any future health campaigns to be effective and reach the most vulnerable populations.
The pursuit to eradicate polio in Kano reveals the complexities and growing difficulties within global health campaigns. The Ebola outbreak reveals perhaps most significantly the flaws within the ideology of eradication which has been so vehemently pursued by the West. The association of polio vaccines as a product of the West will continue to have implications for wider health security in Nigeria and beyond. The complexities discussed here show that vaccinations alone are not enough, future health campaigns must take into consideration the importance of culture and history within regions, as well as geopolitical struggles. Nigeria’s success in controlling the spread of Ebola does not mean that the lessons taught by the polio campaign should be discarded or forgotten.
The views expressed in this article are those of the author and do not necessarily represent the views of Development in Action.
Have an opinion on this or another topic? Why not write for our blog? Click here to find out more and get in touch.