August 23, 2013 - The global effort to eradicate polio, a disease that has been on
the brink of extinction for years, is facing serious setbacks on two continents. The
virus is surging in Somalia and the Horn of Africa, which had been largely free of
cases for several years. And a new outbreak has begun in Pakistan’s North Waziristan
that a warlord declared off limits to vaccinators 14 months ago. The African outbreak
began in May with just two cases of polio paralysis: one in Mogadishu, Somalia’s capital,
and another in the huge Dadaab refugee camp in Kenya, where thousands of Somalis have
fled fighting between Islamic militants, clan militias, government troops and African
peacekeepers. Now there are 121 cases in the region; last year, there were only 223
in the world. The new Pakistan outbreak in North Waziristan, near the frontier with
Afghanistan, is in an area where a warlord banned polio vaccinations after it was
disclosed that the C.I.A. had staged a hepatitis vaccination campaign in its hunt
for Osama bin Laden. The warlord, Hafiz Gul Bahadur, banned all efforts until American
drone strikes ended. Although only three North Waziristan children have suffered
polio paralysis since then, even one case shows that the virus is in the area and
could spread. The new outbreaks may delay a recently announced $5.5 billion plan
to eradicate polio by 2018. Nonetheless, public health officials still believe that,
with enough local political will and donor money, they can prevail by using techniques
that have worked before. The Pakistan outbreak is particularly frustrating because
eradication had been going steadily forward despite the killings in December of nine
vaccinators for which some blamed the Taliban. Public health officials had counted
themselves lucky that despite simultaneous vaccination bans in North and South Waziristan,
no polio virus was known to be circulating in the 250,000 children in those areas.
Vaccination posts were set up on nearby highways and on buses and trains. Urban hospitals
packed the vaccine on ice for families willing to smuggle it back to neighbors. But
it was not enough.