The Pakistani government has made safe-haven for refugees conditional on receiving polio vaccinations.

In the fight to end polio, the Pakistani government has for the past year made safe-haven for internally displaced persons (IDPs) conditional on receiving polio vaccinations.

The country’s ruling party, the Pakistan Muslim League, has made polio drops mandatory for anyone leaving the country’s tribal areas – the regions in which the worst polio outbreaks have occurred. Previous voluntary vaccination programs in these regions have failed to eradicate the polio threat.

As the stakes grow higher, the authorities have chosen to prioritize public health over individual consent. A significant number of refugees refuse the vaccine and are turned back at regional checkpoints. In June last year, for example, nearly 40 trucks carrying internally displaced persons (IDPs) from North Waziristan en route to Afghanistan were turned back by the Pakistan army at the Pakistan-Afghan border. The refugees demanded that they be first provided with food and shelter before the administration of the vaccine.

Refugees often believe Taliban authorities, who claim that vaccination is a ‘Western conspiracy’ and will ‘spoil’ (i.e. render infertile) their children. This is not an entirely unfounded claim. In 2011, the CIA used a hepatitis vaccination program as a front to gather intelligence on the whereabouts of Al Qaeda leader Osama bin Laden.

The new government policy has attracted the attention of Western bioethicists. In an article in this month’s edition of the Journal of Medical Ethics, Art Caplan and David L Curry of the NYU School of Medicine argue that states have a right and a responsibility to require vaccination in instances where serious vaccine-preventable diseases threaten local populations.

“Aid can morally be made contingent on vaccination when there is direct, imminent risk to aid givers and nations from whom aid is being sought.”

Surprisingly, Caplan and Curry do not mention the CIA incident that has provided such strong support for Taliban scaremongering. 

Pakistan mandatory vaccination ethical debate
Xavier Symons
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Xavier Symons

Xavier Symons is a bioethicist and scholar in residence at the Kennedy Institute for Ethics at Georgetown University.

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