By Natalie Eisenbarth
Two weeks ago, British newspaper The Guardian published findings of its ongoing investigation into allegations of a fake vaccination program conducted by the U.S. Central Intelligence Agency (CIA) in northwest Pakistan. Under the ruse of providing hepatitis B vaccines, the CIA allegedly attempted to collect DNA samples from Osama bin Laden’s family members in hopes of finding the world’s most wanted terrorist. In response to the allegations, an unnamed U.S. official defended the program saying that the U.S. was expected to use “all tools at its disposal” in the hunt for bin Laden.
Any attempt to use impartial, international public health efforts for counter-terrorism purposes erodes hard-earned trust not only in vaccination programs in Pakistan, but around the world.
Since the story first broke, the response from the blogosphere has been fierce. The Atlantic’s James Fallows disputed the anonymous defense of the CIA’s actions. He argued – not without a touch of hyperbole – that there were some natural, commonly agreed-upon limits to the idea of the U.S. using “all tools at its disposal”. For example, most would agree that the U.S. using an atomic bomb against Abbottabad or unleashing anthrax in the area would be too costly measures.
In a Washington Post op-ed, Orin Levine and Laurie Garrett described the years it has taken to build trust – particularly in Muslim communities – for immunization efforts. They describe how in Afghanistan and Pakistan, this trust is intimately linked to trust in other health efforts aimed at improving child and maternal health and expanding the supply of safe drinking water. Undermine a community’s willingness to participate in vaccination campaigns and you erode your ability to make a positive impact on community health more broadly.
And it’s important to remember that – as one commentator pointed out – the diseases that vaccines attempt to contain aren’t constrained by geographic boundaries. Even the least benevolent among us have reason to worry when people, for fear of underhanded motives, decline to participate in immunization campaigns. In the light of a possible epidemic growing out of control because of widespread distrust of vaccine interventions, Fallows doesn’t seem so hyperbolic after all.
The CIA’s alleged tactics also put humanitarian workers at risk. The fake immunization campaign casts suspicion on all humanitarian actors, in Pakistan and elsewhere. From some quarters, this suspicion might erupt into open hostilities against aid workers if the humanitarians are suspected of being associated with an undercover plot.
The international humanitarian community – including the international NGOs in the InterAction alliance – work hard to maintain an identity that is independent from official U.S. action. In many countries, this independence is what allows us to reach those most in need. Distrust of the U.S. government (and, admittedly, outsiders in general) runs high in Pakistan. NGOs must take great care to avoid overt association with the U.S. government. In doing so, they are able to reach populations that might otherwise be inaccessible.
It is imperative that independent, impartial humanitarian action be kept free from the taint of intelligence-gathering and military efforts. The lives of populations in need, humanitarian workers and, in the end, all of us, depend on it.