Pakistan: Fanaticism Risks Polio – Analysis


By Tushar Ranjan Mohanty*

On May 31, 2023, a soldier was killed when terrorists opened fire on members of a polio inoculation team in the Spinwam area of North Waziristan District in Khyber Pakhtunkhwa (KP). 

On May 25, 2023, three Policemen, accompanying a polio vaccination team, were injured in an attack by militants near Mirdarra Bridge in the Bagh-Maidan Markaz area of Tirah Tehsil (revenue unit) in the Khyber District of KP. 

On May 19, 2023, a Police Constable, identified as Shahzad Ahmad Bangalzai, was killed in an attack on female workers of a polio vaccination team in the rural areas of Kali Kariz, a suburban area of Mastung District in Balochistan. The members of the anti-polio team remained unharmed in the attack. 

These three incidents of attack targeting polio vaccination team and the Security Forces (SFs) giving protection to the polio campaign launched on May 15, 2023, under the second phase of the Sub-National Immunization Campaign 2023, in selected Districts of all the provinces. The second phase campaign which started on May 15 and ended on June 6 was held in three parts. The first part was conducted from May 15-19 in 12 Districts of Punjab including Islamabad, 18 Districts of Balochistan and 17 Districts of Sindh. The second part was conducted from May 22-26 in 22 Districts of KP. In the third part, May 29-June 5, it was conducted in the seven Districts of Southern KP and Quetta (Balochistan). 

The first phase of the Sub-National Immunization campaign was held on January 16, 2023, and, unlike most of the earlier phases as well as the second phase of 2023, was peaceful, with no attacks recorded. However, before the campaign day, five Police personnel deployed on the security of polio workers were injured when unidentified terrorists opened fire and threw hand grenades on their vehicle at Hussaini Chowk in Dera Ismail Khan town (Dera Ismail Khan District) in KP on January 5, 2023. One terrorist also sustained injuries in retaliatory fire by Police personnel. However, the terrorists managed to escape. 

The polio immunization campaign held in four phases in 2022 was also marred by terrorist violence. According to partial data compiled by the South Asia Terrorism Portal (SATP), at least seven Policemen and two Polio workers were killed during the 2022 campaign. While the first phase, January 17-January 24, was by and large peaceful, there was one incident of killing of a Policeman on January 25. The second phase, June 27-July 3, claimed three lives, including two policemen and one polio worker. Though the third phase, August 19–August 29, did not witness any violence, two Policemen escorting a polio team for a survey in the area were killed by armed men on August 16, in the Tank District of KP. 

The fourth phase was conducted between October 24–30, during which two incidents of attack were reported, in which two Policemen were killed. 

The first polio immunisation-linked incident of violence 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 131 persons (58 health workers and 73 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 attacks targeting the inoculation campaign. There were 18 fatalities (eight polio workers and 10 SF personnel) 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 United States 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 Islamist fatwas (religious edicts) from orthodox or extremist forces in the country. An early 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, curiously, until the CIA stopped its drone strikes in the region. Bahadur’s declaration was a reflection of the consensus reached by various terrorist outfits that formed the Shura-e-Mujaheddin (Council of Islamic fighters). 

Again, on July 31, 2019, TTP warned people against polio vaccination. The one-page message in Urdu seen by people in Miranshah, the headquarters of the 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 extremists 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 the December 10-13, 2021, campaign, three incidents of attack were reported in which two policemen were killed and another one sustained injuries.

The Government claims to have 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 50 deaths took place. 

Pakistan is one of just two remaining countries in the world where polio is still categorized as ‘endemic’, the other one being Afghanistan. As of May 31, 2023, there two polio cases have been detected in Pakistan. 20 cases were detected in the country in 2022, one in 2021, and 84 in 2020. 

Despite the Government’s effort to protect each Polio team on ground, the attacks underline the enormous dangers of religious extremism and the enduring risk to countries that fail to overcome the irrational prejudices and fear that have undermined the immunization campaigns in Pakistan, as well as in its equally exposed neighbour, Afghanistan.

  • 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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