This week's tragic reappearance of polio in Kabul, the capital of Afghanistan, after 13 years, poses serious questions about the future of health in the country following the scheduled withdrawal of United States military personnel at the end of 2014. Without their military escorts and protection, humanitarian and non-governmental aid organizations are expected to draw down foreign personnel as well.
Although the polio vaccine is safe, vaccination remains a sensitive topic in the region and aid workers face a mounting wave of cultural challenges. Some militants believe the common misconception that vaccinations are against Islamic law or are administered as part of a broader American plot to sterilize children or infect them with HIV. Taliban in Pakistan have been attacking polio workers and their security teams since it was revealed in 2011 the CIA used a fake Hepatitis B vaccine campaign in Abbottabad as part of an attempt to obtain blood samples from Osama bin Laden's children in order to confirm the al Qaeda chief's location.
Despite the Pakistani government's efforts to provide police protection, at least 31 polio vaccination workers have been killed in Pakistan since July 2012. (Police and security personnel working with them have also been shot at, wounded, and killed.) These attacks, unfortunately, have had their desired effect. Along with systemic problems in supply chains and personnel management, the intimidation and violence have increasinglyled mothers to opt out of all kinds ofvaccines, and have stymied health efforts; outbreaks of vaccine-preventable diseases, such as measles, have increased. And as a result, polio remains unchecked in several provinces, particularly in the tribal regions bordering Afghanistan.