Pakistan needs sensitivity when debating vaccination

Pakistan made headlines recently with its response to having a widely unvaccinated population. Public safety legislation is being used by the Pakistani authorities to arrest parents who do not vaccinate their children against polio. The parents are imprisoned until they sign an affidavit that they will go ahead with vaccination, a decision which removes any parental right of choice. CNN reports that so far there have been over 500 arrests.

According to the World Health Organisation, Pakistan is one of three countries in the world where polio is considered endemic, accounting for 80 per cent of the world’s polio cases, and many are of the opinion that a crackdown on those failing to vaccinate their children is long overdue. However, this universal approach may instead have an extremely detrimental impact as it completely fails to address the motivations behind the anti-vaccination rhetoric.

Many have been quick to draw a comparison between Pakistan and the United States, where those exercising their parental right to refuse to vaccinate their children may have led to a recent spike in measles cases across the country. According to the Centre for Disease Control, last year there were 644 cases across 27 states – a high number considering that the disease was declared officially eradicated there in 2000. Many parents who do not vaccinate their children do so on the grounds of a discredited scientific paper published by a former surgeon, Andrew Wakefield, who claimed there was a direct link between the measles, mumps and rubella (MMR) vaccination and autism in children. But it’s all too easy to draw comparisons between the US and the far more serious situation in Pakistan when the motivations for parents not vaccinating children in the latter are far more significant.

One of the main motivators against vaccination in Pakistan is fear of the Taliban. According to a recent article in Vice, many of the recent cases of polio have occurred in Taliban-controlled areas of the country, where the Taliban have been preventing vaccines from entering the country. This is a result of a previous American-driven vaccination scheme for Hepatitis C, which the Taliban viewed as a spying attempt by the CIA. As a result, any new vaccination initiatives are viewed with much suspicion both by the Taliban and by parents.

The Taliban also deliberately target aid workers who are helping to bring vaccinations to inaccessible regions of the country, further deterring parents from vaccination. By attempting to enforce vaccination in Taliban-occupied and surrounding areas, the Pakistani government’s intentions may be good but they risk endangering the safety of both health workers and parents who choose to vaccinate their children.

The term ‘rights of the parent’ is mentioned frequently in discussions about vaccination. But the situation in Pakistan goes far beyond this, punishing the parents of unvaccinated children for reasons outwith their control. Any trust in western vaccination schemes appears to have been violated and, by using extreme methods to enforce vaccination, the Pakistani government is not helping to rebuild that trust. The rights of the parent are important, the rights of the child more so, but the obstacles which face Pakistan’s fight against polio are deeply entrenched political and ideological problems which need to be addressed before any real progress can be made. The polio epidemic facing Pakistan is one which needs urgent attention, but by imposing such a broad and unfocused approach to mass medication and not considering the rights of parents, the government in Pakistan run the very real risk of alienating many from vaccination altogether and ultimately hurting the very people they are trying to help.

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