Polio, terror and the immunological worldview

ABSTRACT

This paper adopts a socio-historical perspective to explore when, how and why the eradication of poliomyelitis has become politicised to the extent that health workers and security personnel are targeted in drive-by shootings. Discussions of the polio crisis in Afghanistan and Pakistan have tended to focus on Taliban suspicions of a US-led public health intervention and the denunciation of ‘modernity’ by Islamic ‘extremists’. In contrast, this paper considers a broader history of indigenous hostility and resistance to colonial immunisation on the subcontinent, suggesting how interconnected public health and political crises today have reactivated the past and created a continuity between events. The paper explores how the biomedical threat posed by polio has become intertwined with military and governmental discourses premised on the ‘preemptive strike’. Here, the paper tracks the connections between biological immunity and a postcolonial politics that posits an immunological rationale for politico-military interventions. The paper concludes by reflecting on the consequences for global public health of this entanglement of infectious disease with terror.

KEYWORDS:

• Afghanistan
• Pakistan
• polio
• eradication
• crisis
• terror
• immunity
• colonialism

Acknowledgements

I have benefitted from conversations on panic, polio, immunity, and colonial Asia with numerous individuals and would like to thank: Thomas Abraham, Warwick Anderson, David Arnold, Amy Fairchild, Sayeed Khan, Heidi Larson, Jeffrey Martin, Catherine Peckham – and above all the late Aziz Siddiqui and Tony Hyman who, many years ago, introduced me to Khyber Pakhtunkhwa. My thanks to the anonymous reviewer for helpful comments on an earlier draft of this paper.

Disclosure statement

No potential conflict of interest was reported by the author.

ORCiD

Robert Peckham http://orcid.org/0000-0001-8370-609X

Notes

1 For an analysis of President Bush’s rhetorical construction of the ‘war on terror’ after the 9/11 attacks on New York and Washington DC, see Silberstein (2002, pp. 1–38).

2 The last indigenous case of polio in China was reported in 1994 and in 2000 the Regional Commission for the Certification of Poliomyelitis Eradication (RCC) in the WHO Western Pacific Region declared China polio-free; see www.wpro.who.int/china/mediacentre/factsheets/polio/en/.

3 See www.politicalconcepts.org/issue1/crisis/ for Janet Roitman’s definition of ‘crisis’ in Political Concepts: A Critical Lexicon.

4 On this process of collective imagining, see classically Anderson (2006, p. 6).

5 On the importance of outreach and sensitised communication in the polio campaign that followed a 2002 outbreak in India, see Gitanjali (2008).

6 Borders and border-making projects in South Asia tend to be discussed – as they are here – in terms of anxiety and contestation, with less focus on the informal practices of those who live in the ‘borderlands’. For a recent ethnography of everyday life on Bangladesh’s border with India, see Hussain (2013).

7 East Pakistan seceded from West Pakistan in 1971 to become the People’s Republic of Bangladesh after a military conflict.

8 On Obama’s ‘rebooting’ of the war on terror and the continuities of US counter-terrorism policies from the Bush administration, see McCrisken (2011).

9 For an insightful discussion of Agamben’s notion of ‘state of exception’ and ‘indeterminacy’ in relation to the US drone strikes in the FATA, see Gregory (2015).

10 However, the Salafi jihadi militant group ISIL has proclaimed a caliphate and currently controls extensive territory in Iraq and Syria, with a more limited presence in Libya. For a critique of the state-centric assumptions that infuse the term ‘ungoverned spaces’, see Clunan (2010).

11 See, here, the anthropologist Webb Keane’s analysis of the interactions between the Dutch colonial missionaries and adherents of Marafu, an ancestral religion on the island of Sumba in Indonesia during the nineteenth and twentieth centuries (2007).

12 Biological immunity has a long history that may be tracked back to Roman law and to the formulation in the seventeenth century of immunity as a ‘natural right’ to ‘self-defense’. As Ed Cohen has suggested, in the final decades of the nineteenth century these political concepts were incorporated into science and biomedicine with consequences for how the modern body has been understood (2009).

13 Napier’s aim, in fact, is to explore what the consequences may be of over-simplifying immunology as a binary between ‘self’ and ‘non-self’.

14 As Warwick Anderson notes, Derrida had ‘discovered autoimmunity in the 1990s’ (Anderson, 2014, p. 612). For another insightful reflection on Derrida’s theories of autoimmunity and 9/11, see Mitchell (2007, pp. 280–281).

15 Shell observes that ‘polio influenced the formation of these media as much as they influenced the perception of polio on the part of terrified people and nation-states’ (2005, p. 1).

16 In 1994, the WHO Region of the Americas was certified polio-free, followed by the WHO Western Pacific Region in 2000, the WHO European Region in 2002, and the WHO South-East Asia Region in 2014.

17 In 1988, there were some 350,000 reported cases of polio in more than 125 endemic countries. Although there were a total of 416 reported cases in 2013, these included only 160 cases in endemic countries. The other cases were the result of polio’s spread from endemic areas into polio-free areas (Ethiopia, Cameroon, Kenya, Somalia and Syria). The original aim of the WHO had been to eradicate polio by 2000; see www.who.int/mediacentre/factsheets/fs114/en/

18 The majority of the population in the FATA, however, opposes Al-Qaeda and the Taliban; see Bergen (2013, p. xv).

19 The Taliban’s Islamic Emirate of Afghanistan was established in 1996 with Kandahar as the capital, and fell to US forces in 2001.

20 Examples of indigenous opposition to colonial vaccination programmes in Asia and Africa are provided by Atsuko (2006) and Lyons (1992). On the politics of polio eradication in Nigeria, see Renne (2010).

21 The Navy SEALs had taken off in four Chinook helicopters from a base in East Afghanistan. This is an episode portrayed in the 2012 US movie Zero Dark Thirty directed by Kathryn Bigelow. For different accounts of Osama bin Laden’s killing, see Bowden (2012), Hersh (2016), Mazzetti (2013) and Schmidle (2011).

22 Afridi was paid 5.3 million rupees for his service. In the event, he did not succeed in getting into the bin Laden compound. Afridi was subsequently sentenced to imprisonment for plotting against the state and helping the CIA to track bin Laden. The health workers who supported Afridi were also fired and reprimanded for acting ‘against the national interest’; see Leiby (2012).

23 The full letter is reprinted at: www.huffingtonpost.com/2013/01/10/cia-polio-vaccine-hoax_n_2450726.html.

24 For a discussion of how military and humanitarian interventions have become increasingly entangled, see Fassin and Pandolfi (2010).

25 The TNSM, which translates in English as the Movement for the Enforcement of Islamic Law, was established in 1992 and although banned by the Pakistani government of Pervez Musharraf in 2002 remains active on the Afghan-Pakistan border.

26 Immunisation programmes are able to continue when they are sanctioned by local leaders. In 2007, Mullah Muhammad Omar, the spiritual leader of Afghanistan, agreed to protect vaccination teams. In the 1990s, during the civil war, the Taliban and the Northern Alliance ceased hostilities on so-called ‘Days of Tranquility’ so that children could receive vaccines. ISIL has allegedly allowed vaccination teams into areas under its control in Syria and Iraq. In 2016, a video purportedly released by the organisation promoted an ISIL sponsored anti-polio programme in Tikrit.

27 By the same token, novel information technologies, digital mapping and remote sensing, which are used by the military for counterinsurgency, are today being deployed for infectious disease surveillance; see Peckham (2015b).

28 For an argument that the United States should be regarded as an imperial power and that imperial formations ‘thrive on turbid taxonomies that produce shadow populations and ever-improved coercive measures to protect the common good against those deemed threats to it’, see Stoler (2006, p. 128).

29 Sub-districts within the provinces of KP and Baluchistan are also Provincially Administered Tribal Areas (PATA).

30 The border was revised as a result of the Anglo-Afghan Treaty of 1919. Today the border separates KP, FATA, Baluchistan, and Gilgit-Baltistan in northern and western Pakistan from the northeastern and southern provinces of Afghanistan.

31 For another, somewhat differently inflected account of polio eradication efforts in Pakistan, see Closser (2010).