Polio Wars: Conspiracy and Democracy in Pakistan

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A doctor in Pakistan checking children for Polio vaccination. Image: CDC Global/Flickr

This article was originally published by OpenDemocracy on 18 September, 2015.

Between December 2012 and early 2015, 78 people were murdered and dozens of others injured because they tried to administer a polio vaccine to children.  They were killed because of a claim that the vaccines in their coolboxes were actually chemical devices in a western plot to sterilise Muslims.

These killings all took place in Pakistan, the archetypal ‘failed state’. What better evidence can there be that the country is a nest of terrorists than that it cannot stop the murder of medics trying to wipe out a deadly, crippling disease – all because of a conspiracy theory?

In the midst of these killings, though, something happened that has never happened in Pakistan before. One democratically elected political party handed over power to another, in a general election in which 55 per cent of people eligible to vote turned out. It was an event supported by all major Pakistani media outlets, including those that have sided in the past with the military and against civilian rule.

So as the wave of killings of vaccine workers continues (although much diminished), which of these two pictures is wrong: ‘failed state’ or – however we hedge this – ‘democratic state’?  And what kind of threat has the vaccination conspiracy theory posed to democratic aspirations in Pakistan?

The answers require a short history of the conspiracy theory itself.

It all seems to have started in northern Nigeria in 2003, when a physician and Islamist called Dr Ibrahim Datti Ahmed accused the Americans of lacing the polio vaccine with an anti-fertility agent. By mid-2004, this theory had jumped to India, and by 2005, sixteen countries where polio had been eradicated were reporting outbreaks of infection. Even so, by 2012 the number of countries where polio was endemic was down to just three: Nigeria, Afghanistan and, by far the worst, Pakistan.

In June that year, a Pakistani Taliban leader called Gul Bahadur issued a fatwa in which he announced, “a ban on [the] polio vaccination campaign from today… anybody who disrespects this order will not have the right to complain about any loss or harm.”

Just a month later, details were revealed by Pakistani authorities of how a Pakistani medic, Shakil Afridi, had been hired by the CIA in 2011 to create a fake vaccination programme (for hepatitis B rather than polio) in order to try to confirm the location of Osama bin Laden.

The vaccination conspiracy theory was now both weaponised and supported by “evidence” of past US interference. When the killings began in 2012, one of the first results was a dramatic spike in polio infection.

But the murders also created headlines around the world, and provoked a reaction in Pakistan itself, expressed through mainstream and social media.   Eventually, in January 2014, the Pakistani Taliban declared that it was no longer opposed in principle to polio vaccinations, albeit with the warning that, “we simply cannot allow vaccinators when we have the case of Shakil Afridi in front of us.” Another Taliban leader admitted that, “unfortunately there are still some elements within the [Pakistani Taliban] who believe in baseless conspiracy theories.”

A year later, the killings have slowed, the government has resumed its vaccination programme, and, according to the WHO, the rate of infection in Pakistan has fallen by 70 per cent since 2014.

The exertion of public pressure to stop the killings happened in at least some part through a national and local media – liberalised ironically by a military dictator, Pervez Musharraf, in 2002 – that provided a platform for objection. So a key ingredient of a functioning democracy is at work in these protests against the killings, in the sense that there is a public space, however mediated, for views to be expressed and exchanged.

But democracy is not only about public forums for free expression, but also about legitimacy and rights.

Legitimacy, in the sense, for example, of free and fair elections where one party hands over peacefully to another, is something new to Pakistan. However, the vaccination conspiracy theory, made murderous by the Taliban, posed a serious threat to this legitimacy.

This is because the military in Pakistan has never been under complete control by civilian prime ministers or legislatures, and yet it fell largely to the military to tackle the killings at source. Anything that requires the still relatively unfettered military to step in erodes power exercised democratically. It also fits a damaging narrative to the outside world: that it’s the military that keeps Pakistan from falling completely into a failed-state abyss, therefore it’s the military that should receive the lion’s share of foreign aid.

Furthermore, the fact that the attacks were claimed by the Pakistani Taliban meant that this was a sustained assault orchestrated by the single largest internal threat to democratic rule. The Taliban committed to destroying democracy: it has successfully, if briefly, taken over a substantial part of the north of the country (Swat Valley in 2006-7), destroying schools and famously attempting to murder the schoolgirl blogger Malala Yousafzai, and it has carried out an horrendous massacre of schoolchildren at an Army school in Peshawar.

As for rights, the Taliban’s attacks and the conspiracy theory that justified them, threatened people in the large pools of poverty and discrimination, including the largest registered refugee community in the world: Afghans who have fled war, and have settled in the slums of Karachi, Peshawar and the tribal areas. None of these refugees has political rights – the right to vote, for example – in Pakistan.  Therefore their voice is diminished in the face of these attacks – something that’s reinforced by low literacy rates, as well as an adherence among some in the refugee camps to the very conspiracy theory used to justify attacks on those who try to protect their children from disease.

While political rights (the right to vote), civil rights (the right to be free of discrimination) and property rights (the right to secure title of land) are enshrined in the Pakistani constitution, they remain elusive for people on the margins of Pakistani society. They are then further diminished by the actions of a militant-led campaign of murder reminiscent of the mayhem the refugees had fled from in the first place.

So if democracy is making steady inroads into the institutional fabric of Pakistan, the violence that accompanied the vaccination conspiracy theory has posed a serious challenge.

There are still, though, reasons for optimism. Not only did a wave of strong public objection seem to weigh on the Taliban’s commitment to its campaign; but a general election did take place (although in the face of violence, some of it from the Taliban) and political parties did peaceably swap sides between government and opposition. There are other encouraging indicators too, including a persistent rise in literacy rates in the last three decades.

But from a western point of view, the critical point is this: we need to change the narrative. Pakistan is not a failed state. The polio murders have disrupted and camouflaged the extent to which the country has, against severe odds, strengthened its democratic commitments. Nor is Pakistan saved from failed-statehood by pouring billions more into military coffers at the expense of governance, education, health and the public sphere.

If the deadly effectiveness of the vaccination conspiracy theory was measured by a spike in polio infection rates in Pakistan, the capacity of the country’s political institutions to respond is measured at least in part by the fact that the country is back on track, finally, to wiping out the scourge of polio altogether.

David Hickman produced the Sundance Film Festival-winning A Brief History of Time, and was producer and director of two Emmy award-winning science series for Channel 4 and US television. He is currently developing a documentary project that will take ten years to complete, and will be filmed in Karachi, Mexico City and Naples. As a frequent visitor to Pakistan, he has travelled and filmed extensively throughout the country. Since 2009, he has been senior lecturer in film and television production at the University of York.

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