Pakistan: Polio Peril – Analysis


By Tushar Ranjan Mohanty*

On July 2, 2022, a polio worker was shot at and injured by unidentified assailants in Madakhel area of Mir Ali tehsil (revenue unit) in North Waziristan District of Khyber Pakhtunkhwa (KP).

On June 28, 2022, unidentified assailants shot dead two Policemen and one polio worker in Datta Khel area of North Waziristan District. The Policemen were assigned to polio vaccination teams in Datta Khel area. The team was administering polio vaccinations when they came under attack. A child was also shot in the leg during the incident.

On May 17, 2022, unidentified militants abducted a doctor, Zeeshan, affiliated with the anti-polio programme, from the Mir Ali area of North Waziristan District. Zeeshan was rescued on May 26. Bannu Division Commissioner Arshad Khan stated that the safe recovery was made possible due to the efforts of law enforcement agencies and tribal elders.

On March 2, 2022, unidentified assailants shot dead a polio worker, identified as Iqra Iqbal, when she was returning home after taking part in the anti-polio campaign on the outskirt of Peshawar, the provincial capital of KP.  

On February 22, 2022, at least five Police personnel were injured in a remote-controlled blast near a Police van deployed for polio duty at Ibrahim Bridge on Maddi Road Gara in the Kulachi tehsil  of Dera Ismail Khan District, KP.

On January 25, 2022, unidentified assailants shot dead a policeman who was providing security for polio vaccination workers in the Kohat District of KP.

According to partial data compiled by the South Asia Terrorism Portal (SATP), at least three Policemen and two Polio workers have been killed in such attacks in the current year (data till July 3, 2022).

The first polio immunisation-linked violent incident recorded by the SATP database, was reported on July 20, 2012, when unidentified terrorists shot dead Doctor Ishaq, associated with the World Health Organization’s (WHO’s) Polio Prevention Campaign, at Al-Asif Square in Junejo Town, Karachi, the provincial capital of Sindh. At least 127 persons (58 health workers and 69 Policemen) have been killed in such violence since then. Another 84 persons (54 health workers and 30 policemen) have been injured in such violence.

In 2012, at least 13 persons (all polio workers) were killed in such attacks. There were 18 [eight polio workers and 10 Security Force (SF) personnel] fatalities in 2013; 39 (12 polio workers and 27 SF personnel) in 2014; 12 (six polio workers and six SF personnel) in 2015; 13 (five polio workers and eight SF personnel) in 2016; none in 2017; six (five polio workers and one SF trooper) in 2018; eight (four polio workers and four SF personnel) in 2019; five (three polio workers and two SF personnel) in 2020; and eight (all SF personnel) in 2021.  

Islamist terrorists violently oppose all forms of inoculation, and their resistance grew after the Central Intelligence Agency (CIA) reportedly organised a fake vaccination drive by Doctor Shakil Afridi, to track down Al-Qaeda’s former chief Osama Bin Laden, who was killed at Abbottabad, KP, by US SEALs in the intervening night of May 1-2, 2011. Terrorists and extremists also spread negative propaganda against the vaccination campaigns, including the canard that the vaccination drops were part of a western plot to sterilise Muslims.

The polio vaccination campaign in Pakistan has not only suffered at the hands of terrorists but also due to socio-religious setbacks that resulted from Islamist Fatwas (religious edicts). The first such Fatwa came from cleric Maulvi Ibrahim Chisti in Muzaffargarh District of Punjab on June 12, 2012. Declaring the anti-polio campaign “un-Islamic,” Chisti had warned that a jihad (holy war) would be launched against polio vaccination teams.

Subsequent to Chisti’s ‘divine formulation,’ the then ‘commander of the Tehreek-e-Taliban Pakistan (TTP)’s erstwhile North Waziristan Agency (NWA) ‘chapter,’ Hafiz Gul Bahadur, issued a Fatwa on June 18, 2012, denouncing vaccinations as an American ploy to sterilise the Muslim community and banned these in NWA until the CIA stopped its drone strikes in the region. Bahadur’s declaration was a reflection of the consensus reached by the various terrorist outfits that formed the Shura-e-Mujaheddin (Council of Islamic fighters).

Again, on July 31, 2019, TTP had warned people against polio vaccination. The one-page message in Urdu seen by people in Miranshah, the headquarters of North Waziristan District, cautioned the public not to allow administration of polio drops to children or to be ready to ‘face dire consequences’ for their defiance. There were two Polio campaigns immediately after the July threat, in August 2019 and December 2019. A three-day campaign was conducted on August 26-28, 2019, during which no one was killed. However, during the five-day campaign conducted on December 16-20, 2019, two Policemen deployed for the security of polio teams were killed by unidentified assailants in the Maidan area of Lower Dir city (Lower Dir District) of KP on December 18. Due to the COVID-19 outbreak, all polio campaigns were suspended in the country thereafter.   

After the COVID-19 crisis diminished, as soon as polio campaign was restarted, the attacks by the extremist resumed. During the August 2-6, 2021 campaign, three attacks on Polio workers and their security team were reported in which two policemen were killed and another policeman sustained injuries. Similarly, during December 10-13, 2021 campaign, three incidents of attack were reported in which two policemen were killed and another policeman sustained injuries.

Though the first Sub-National Immunisation Days (SNIDs) campaign of the current year (2022) on January 17 and January 24 was, by and large, peaceful, there was one incident of killing of a Policeman on January 25. The second SNIDs campaign – June 27 and July 3 – claimed three lives, including two policemen and one polio worker. The second SNIDs campaign of the year aims to vaccinate 12.6 million children in all four provinces. Under the campaign, covering 25 very high-risk districts for poliovirus, children under the age of five will be vaccinated. Further details of the campaign were not available at the time of writing.

This is despite the Government’s claims of having provided fool proof security to the vaccination teams. Pakistan National Coordinator for the Polio programme, Brigadier Doctor Shahzad Baig reiterated, on June 20, 2022,

Every team is escorted by security, by law enforcement agencies, either police [or] army. And I want to bring it on notice that, so far, the polio program has lost 50 lives in the line of duty to extremist bombings and shootings.

He did not, however, specify the period over which these deaths took place.

Pakistan’s failed efforts to provide security for the vaccination teams continues to impede its Polio eradication programme. Eleven cases of polio have already been reported in the country in 2022, all from the North Waziristan District. Not surprisingly, Pakistan and Afghanistan, where armed Islamist extremists exercise widespread influence, are the only two countries remaining on the WHO’s ‘polio-endemic nations’ list. WHO notes,

Polio remains endemic in two countries Afghanistan and Pakistan. Until poliovirus transmission is interrupted in these countries, all countries remain at risk of importation of polio, especially vulnerable countries with weak public health and immunization services and travel or trade links to endemic countries.

Extremism in Pakistan and Afghanistan – substantially kept alive by the State and it’s harnessing of Islamist extremist politics – has prevented the eradication of polio in the two countries, and puts the world at risk. It is abundantly clear that the Polio eradication in these two countries cannot succeed as long as the ideology of Islamist extremism and associated armed violence continue to dominate the political discourse.

*Tushar Ranjan Mohanty
Research Associate, Institute for Conflict Management


SATP, or the South Asia Terrorism Portal (SATP) publishes the South Asia Intelligence Review, and is a product of The Institute for Conflict Management, a non-Profit Society set up in 1997 in New Delhi, and which is committed to the continuous evaluation and resolution of problems of internal security in South Asia. The Institute was set up on the initiative of, and is presently headed by, its President, Mr. K.P.S. Gill, IPS (Retd).

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