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As Disneyland Measles Outbreak Rages in California, Pakistani Father Arrested After Unvaccinated Son Contracts Polio

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There is very interesting news out of Pakistan today that the father of a child who has developed polio has been arrested because he refused to allow his son to be vaccinated:

After a polio case was detected here on Thur­sday, the Kohat administration arrested the father of the affected child because he had refused to get his child vaccinated against polio when vaccinators visited his home. Two health supervisors and a patwari have also been taken into custody for showing negligence in performing their duty.

Three-year-old Moham­mad is the second victim of polio in Dhodha area of Kohat district this year.

Deputy Commissioner of Kohat Riaz Khan Mehsud told Dawn on telephone that he issued orders for arrest after an inquiry revealed that the father of the affected child, Mullah Mohammad Yousuf, had not allowed vaccinators to give polio drops to his son.

But Yousuf is not the only parent who has been arrested:

He said 56 people had so far been arrested this year for refusing to get their children vaccinated against polio.

Also on Thursday, two men were arrested in Kohat for not allowing vaccinators to give polio drops to their children. They were identified as Amir Khan and Hassan Khan.

Islamic extremist groups in Pakistan agitate against polio vaccines, spreading conspiracy theories that the vaccines are Western attempts to kill or dominate Muslims. They even attack health workers and in 2014, those attacks killed more people administering vaccines than the disease itself killed.

But of course, in a civilized country like the United States, there couldn’t be misguided attempts to prevent vaccination despite the solid scientific basis of the public health benefits of vaccines, could there? Sadly, the mass delusion that has led far too many parents to leave their children unvaccinated due to unfounded fears of autism is having the very predictable result of outbreaks of viral diseases previously under control. Here’s the latest on the current outbreak of measles that epidemiologists have traced to Disneyland. Unfortunately, we are learning that because of the reckless behavior of not vaccinating children, even those who have been vaccinated are now developing the disease because of the increased exposure from the outbreak: Read more →

Pakistan Military Offensive in North Waziristan Unleashed

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Because I was away on an extended family trip ending last week, I was unable to comment on Pakistan launching a full-blown military operation in North Waziristan. Many had long held the view that such action would never be undertaken, but it would seem that terrorist attacks in several locations around Pakistan at a time when the government was attempting to hold peace talks with the Taliban finally provoked military action. Dawn provides this interactive map of major events so far. As you mouse over the map, blue circles are air strikes, green circles are ground attacks and red circles are drone strikes. Details should pop up at each circle:

The operation is named Zarb-e-Azb. In the Express Tribune’s summary of the actions, we get this translation of the name:

The meaning of Zarb-e-Azb is sharp and cutting. It’s reportedly the sword used by Prophet Muhammad (pbuh) in the battle of Badar.

The same Express Tribune story carries the June 15 announcement of the offensive by ISPR (Inter-Services Public Relations):

ISPR press release announces launch of military operation.

“DG ISPR has said that on the directions of the Government, Armed forces of Pakistan have launched a comprehensive operation against foreign and local terrorists who are hiding in sanctuaries in North Waziristan Agency. The operation has been named Zarb-e-Azb,” said the press release.

The ISPR statement went on to add that terrorists in North Waziristan had waged a war against the state of Pakistan and had been disrupting life in all its dimensions, stunting our economic growth and causing enormous loss of life and property. “They had also paralysed life within the agency and had perpetually terrorised the entire peace loving and patriotic local population,” the statement added.

“Our valiant armed forces have been tasked to eliminate these terrorists regardless of hue and colour, along with their sanctuaries. With the support of the entire nation, and in coordination with other state institutions and Law Enforcement Agencies, these enemies of the state will be denied space anywhere across the country. As always, armed forces of Pakistan will not hesitate in rendering any sacrifice for the motherland,” said the statement.

The operation has included air strikes by Pakistan’s air force along with ground action. Notably, there also have been at least three US drone strikes apparently coordinated with the offensive.

Remarkably, Pakistan’s Foreign Office is warning diplomats in Karachi to be on guard and to restrict their movements. Although the warning does not appear to mention a link to the action in North Waziristan, it seems likely that the military action is seen as contributing to increased risk of terror attacks across the country.

As might be expected, the military action has precipitated a huge spike in internally displaced people. Since those displaced are coming from the region where radical groups have disrupted vaccination plans, there is concern that polio will be spreading as residents are displaced. However, officials are making the best of a bad situation and are using the movement of families as an opportunity to vaccinate children as they cross checkpoints:

On the one hand, the movement of internally displaced persons (IDPs) from North Waziristan Agency provides officials an opportunity to vaccinate children who were inaccessible to health workers since June 2012, on the other hand, there are concerns that the virus could spread with the movement of these children.

These fears are exacerbated by the fact that the movement is taking place during the summer season, a high transmission season for the poliovirus.

Speaking with The Express Tribune, Acting Country Head of World Health (WHO) in Pakistan Dr Nima Saeed Abid said all efforts are being made to vaccinate children from Waziristan at checkpoints set up for IDPs.

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So far a total of 221,253 children have been vaccinated against polio at check posts set up, according to the Prime Minister’s Polio Monitoring and Coordination Cell.

I will try to keep an eye on developments in this operation but will be traveling again next week.

Postscript: While this post was being written, Pakistan announced that the Haqqani Network is among the targets of the offensive but that the offensive is Pakistan’s alone rather than a joint US-Pakistan action. How can US drone strikes be part of a Pakistan-only offensive? It also should be noted that the military is providing death toll information for “terrorists” and soldiers but does not mention civilian deaths.

CIA, Pakistan Taliban Bring Fighters to Syria…and a Global Polio Emergency

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Recall that last fall, Barack Obama spent some time altering the public record on when CIA-trained death squads first entered Syria to move the date from just before the Ghouta sarin attack to just after (while also trying to shrink the size of those first groups). But the US was a month behind Pakistan’s Taliban, who also sent fighters to Syria, ostensibly on the same side as us this time, to fight pro-Assad forces. But while these efforts on the same side in Syria are having little success as Assad remains in power and might even be gaining the upper hand, the work of the CIA and Taliban on opposite sides in Pakistan has produced a devastating result, with the World Health Organization announcing yesterday that it has declared a Public Health Emergency of International Concern over the spread of polio to countries where it previously had been eradicated:

After discussion and deliberation on the information provided, and in the context of the global polio eradication initiative, the Committee advised that the international spread of polio to date in 2014 constitutes an ‘extraordinary event’ and a public health risk to other States for which a coordinated international response is essential. The current situation stands in stark contrast to the near-cessation of international spread of wild poliovirus from January 2012 through the 2013 low transmission season for this disease (i.e. January to April). If unchecked, this situation could result in failure to eradicate globally one of the world’s most serious vaccine preventable diseases. It was the unanimous view of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have been met.

Although fundamentalist Islamic groups have long accused vaccination campaigns, and especially polio vaccinations, of being efforts by the West to sterilize Muslims, the very high profile case of Dr. Shakeel Afridi carrying out a hepatitis vaccination ruse on on behalf of the CIA in an effort to obtain blood samples from Osama bin Laden’s compound in Abbottabad provided a refreshed incentive for attacks on vaccine programs.

Marcy pointed out the stupidity of Leon Panetta’s confirmation that Afridi worked with the CIA in the ruse the day before Panetta’s 60 Minutes segment ran:

Not only does this presumably put more pressure on Pakistan to convict Afridi of treason (he remains in custody), but it exacerbates the problem of having used a vaccination campaign as cover in the first place, confirming on the record that similar campaigns in poor countries might be no more than a CIA front.

I presume someone in the White House gave Panetta permission to go blab this on 60 Minutes; I assume he’s in no more legal jeopardy than Dick Cheney was when he insta-declassified Valerie Plame’s identity.

But shit like this discredits every single claim national security experts make about the need for secrecy. I mean, how are CIA officers ever going to recruit any more assets when the assets know that the CIA director may, at some time in the future that’s politically convenient, go on 60 Minutes and confirm the relationship?

Afridi was eventually sentenced to 30 years imprisonment, not on treason but on other dubious charges and in a shopped venue. And the fallout in Pakistan’s tribal areas from US confirmation of the vaccination ruse was exactly as might be expected: multiple deadly attacks on polio vaccine workers and many new cases of paralyzed children.

While the polio virus circulating in Syria doesn’t appear to have come directly with the Taliban fighters sent from Pakistan, it is indeed a strain from Pakistan’s tribal areas that is in Syria now:

Thirteen cases of wild poliovirus type 1 (WPV1) have been confirmed in the Syrian Arab Republic. Genetic sequencing indicates that the isolated viruses are most closely linked to virus detected in environmental samples in Egypt in December 2012 (which in turn had been linked to wild poliovirus circulating in Pakistan).

WHO is recommending drastic measures, primarily calling for all travelers from Pakistan, Cameroon and Syria to be vaccinated for polio, preferably at least four weeks prior to international travel, but at least at departure if it hasn’t been done earlier. WHO is also calling for increased efforts in vaccinations in countries (Afghanistan, Equatorial Guinea, Ethiopia, Iraq, Israel, Somalia and Nigeria) where the virus is known to be present but from which transmission has not been seen.

So the fears from two years ago on the impact of the CIA’s actions on polio eradication are now met. But keep in mind that it’s not just vaccine programs that were put at risk by this incredibly stupid move. A large alliance of humanitarian groups complained directly to the CIA that all humanitarian groups were put at risk by the move, since the CIA ruse was carried out under cover of a humanitarian organization. Will John Brennan be able to heed this advice?

More Fallout From Hakimullah Mehsud Drone Killing: Polio Vaccines Halted in Waziristan

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Yesterday, we got the tremendous news that after having lead the world in the number of polio cases as recently as 2009, the World Health Organization announced that there have been zero polio cases in India for three consecutive years. In today’s Express Tribune, we see a discussion of whether and how Pakistan can now rise to the challenge of polio eradication. In the article, we learn that the US drone killing of Pakistan Taliban leader Hakimullah Mehsud not only disrupted the developing plans for peace talks between the Taliban and Pakistan’s government, but it also affected polio vaccinations in North and South Waziristan:

According to the State Minister for National Health Services, Regulations and Coordination Saira Afzal Tarrar, NWA and South Waziristan did not receive any immunisation in months, contrary to former North Waziristan Agency (NWA) surgeon Jan Mir Khan, who was part of recent polio efforts. “After the drone strike that killed Hakimullah, it all stopped. Not just the peace talks, but also our efforts,” she says.

The terrible impact of the CIA’s vaccination ruse employing Dr. Shakeel Afridi in the search for Osama bin Laden has been extensively documented here, but this is the first time I have seen a suggestion that backlash to a drone strike directly resulted in polio vaccines being denied to children. Tarrar is not ready to give up, however, and believes that Pakistan and the Taliban will eventually come to an agreement that will allow vaccinations to resume:

Saira Tarrar also emphasised that the people of the area need to be part of the solution. “Parents are now sick of the ban; this pressurises the Taliban.”

“There is an accessibility problem in Fata, but by 2014, we will get a bargain and get some access.” And access is key, as far as Elias Durray, the head of Polio Eradication at the World Health Organization in Pakistan is concerned. “Immunisation prevents circulation. The virus won’t vanish on its own.”

Let us hope that Pakistan can achieve full vaccine coverage and have polio disappear as quickly in Pakistan as it did in India. Of course, this will require the US actually letting peace negotiations between the Taliban and Pakistan come to fruition, so success is far from guaranteed.

WHO, Bill Gates and Islamic Scholars All Push For Polio Vaccination in Province Now Governed by Khan’s PTI

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There are public calls on a remarkable number of different fronts for a renewed commitment to polio vaccination in the Khyber Pakhtunkhwa province of Pakistan, which is now governed by Imran Khan’s PTI party. Direct appeals to Khan are coming from the World Health Organization and from Bill Gates. A major conference of Islamic scholars also came out with a statement backing polio immunization and providing push-back against the view that immunization campaigns aim to sterilize Muslims or are run by Western intelligence agencies.

Dawn gives us the details of the WHO push:

World Health Organisation, Pakistan polio chief Dr Elias Durry on Thursday apprised Pakistan Tehreek-i-Insaf chairman Imran Khan in Lahore of the threat to the health of Khyber Pakhtunkhwa children due to non-vaccination, it is learned. PTI, which has the most seats in the Khyber Pakhtunkhwa Assembly, leads a coalition government in the province.

According to the relevant officials, the meeting has coincided with the confirmation of three fresh polio cases from Federally Administered Tribal Areas by National Institute of Health.

They said Fata had reported five, Khyber Pakhtunkhwa four and Sindh two of this year’s 13 countrywide polio cases.

Khan is eager to help in the campaign and has taken part in promoting immunization before his party was elected to govern KP:

The officials said WHO had publicly recorded its reservations about polio eradication efforts in Khyber Pakhtunkhwa, especially in Peshawar.

They said the PTI chairman, who had inaugurated various polio campaigns in the country’s several cities, apprised the WHO, Pakistan polio chief of his eagerness to see fight against polio succeed.

The officials said Imran Khan carefully listened to Dr Elias Durry’s concerns about Khyber Pakhtunkhwa children’s vaccination and assured him that he would convey them to the PTI-led provincial government for necessary action on emergency basis.

“Imran Khan said he would issue special instructions to the provincial chief minister (who belongs to PTI) to ensure vaccination of all children under five as ensuring better health care in the province is his government’s top priority,” an official said.

Also joining the push for immunization is Bill Gates, as we learn from the Express Tribune:

Famous American business magnate Bill Gates has sought Imran Khan’s cooperation to eradicate polio in Khyber-Pakhtunkhwa, as the province apparently failed to provide security to polio workers.

Gates sent a personal letter through his emissary to chairman Pakistan Tehreek-e-Insaf (PT) Imran Khan asking for his party’s cooperation in furthering the anti polio vaccination programme in Khyber Pakhtunkhwa, said an official statement.

Imran Khan is scheduled to speak to him on the phone to discuss modalities of moving against polio which takes the lives of so many children in Pakistan especially in Khyber Pakhtunkhwa.

Especially welcome news comes from a meeting held by Islamic scholars who produced a statement in favor of immunization and condemning the killing of vaccination workers. They also condemned Dr. Shakil Afridi and any other participation of intelligence agencies in vaccination programs: Read more →

Sad Victory for Pakistan’s Taliban: Child Diagnosed With Polio in Region Where Vaccinations Were Denied

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While much attention is appropriately focused on the horrific and brutal attacks by Pakistan’s Taliban on secular political parties as the country approaches elections in its first-ever transition from one civilian government to another, we have news today of a sad triumph by the Taliban as a child in North Waziristan has been diagnosed with polio after the Taliban successfully shut down polio immunizations there last summer.

Health workers are on the cusp of making polio the second disease after smallpox to be completely eradicated from the planet. The latest plan forecasts eradication by 2018, but a huge barrier is that conservative Islamic groups view Western vaccination programs as attempts to sterilize Muslims. In addition, the participation by Dr. Shakeel Afridi in a bogus vaccination program set up by the CIA to obtain DNA samples from Osama bin Laden’s compound added fresh fuel to the belief that vaccination programs also are used to spy on Muslims. Just under a month ago, a policeman protecting workers administering polio vaccine was shot and killed:

The latest attack took place in the afternoon in the Par Hoti neighborhood of the Mardan district in Khyber-Pakhtunkhwa Province. The policemen, Raj Wali and Mohammad Ishfaq, were accompanying two female workers on the second day of a three-day anti-polio drive, said Wajid Ali, a local police official.

The policemen were standing guard in the street as the health workers administered drops inside a house when an unidentified gunman, who appeared to be in his early 20s, walked up to them and opened fire. Mr. Wali was killed and Mr. Ishfaq was wounded, Mr. Ali said in a telephone interview. The gunman escaped.

That killing followed the deaths of eight vaccine workers last December and the violence has led to a significant interruption in the distribution of the vaccine:

In December, at least eight people engaged in polio vaccinations were shot dead in Karachi and the north-west, and in January and February two police officers were killed in similar attacks.

The UN said last month that some 240,000 children have missed vaccinations since July in parts of Pakistan’s tribal region, the main sanctuary for Islamic militants, because of security concerns.

And it is from the tribal area of Waziristan where we have today’s sad news of a child being diagnosed with polio:

A child has contracted polio for the first time in Pakistan’s militant-infested tribal belt since the Taliban banned vaccinations a year ago, a UN official said Monday.

“The new case has been detected in North Waziristan where we had been denied access in June last year,” the World Health Organization’s (WHO) senior coordinator for polio eradication in Pakistan, Elias Durry, told AFP.

Durry fears that this case is not likely to be isolated:

“We are worried because this new case comes as an example of a bigger impending outbreak of disease in the region,” the WHO official said.

In addition to making vaccination drives shorter and lower profile while working closely with security, the executive summary (pdf) for the new polio eradication plan has a key step of outreach to religious groups:

4. Religious leaders’ advocacy: markedly step up advocacy by international, national and local Islamic leaders to build ownership and solidarity for polio eradication across the Islamic world, including for the protection ofchildren against polio, the sanctity of health workers and the neutrality of health services.

Unfortunately, I don’t see an open call in the plan for bringing about an end to intelligence agencies undertaking new vaccination ruses, although “the neutrality of health services” would seem to touch on it. Meanwhile, Afridi has started a hunger strike in a desperate attempt to keep his name in the headlines.