It's a conspiracy plot straight out of a spy novel: on Monday, the Guardian reported that as part of the Osama Bin Laden capture effort, the Central Intelligence Agency (CIA) set up a fake vaccination clinic in Abbottabad, Pakistan, to collect DNA from Bin Laden's children. The idea was to look for a match with DNA from Bin Laden's sister, who died in early 2010 in Boston, to verify that the Bin Laden family was in the compound before attacking. It's not clear whether the ploy worked; the CIA isn't talking. But the plot has riled some public health experts. They foresee potential harm to real vaccination programs in the developing world, where health workers are trying to overcome pre-existing suspicions about Western medicines. And the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) workers on the ground are keeping a wary eye out for those who might try to exploit public fears.
In Pakistan, the CIA collaborated with a senior government doctor named Shakil Afridi, who is now under arrest for collaborating with foreign agents, according to the Guardian. Health workers under his direction allegedly announced free hepatitis B vaccinations in March and set up a clinic in a poor neighborhood in Abbottabad "to make it look more authentic," the Guardian reported. After the first of the three-part vaccination series was given, the clinic was moved closer to the inner part of Abbottabad where the Bin Laden compound was located. At one point, nurses entered the Bin Laden compound to administer the vaccinations, carrying electronic recording devices, but it's unclear how successful they were in obtaining DNA.
Vaccine program workers, who sometimes struggle to gain public trust and governmental cooperation in the first place, are furious about the deception.
"To take children who are in need of vaccines to prevent some disease that could kill them and use that as a front for something else is unconscionable," says Paul Offit, chief of the Division of Infectious Diseases and the director of the Vaccine Education Center at Children's Hospital of Philadelphia. "The end doesn't always justify the means." Although it appears that children were in fact being vaccinated, Offit says that's irrelevant. "Hiding behind a wonderful and needed program like vaccines is heinous."
Aid workers also say that news of the vaccination plot may undermine their ability to work with the public and with developing world governments. "It's a lot easier to gain people's trust de novo than to try and regain after you've lost it. That's the consequence of these events," says Robert Steinglass of John Snow Inc., a vaccine contractor that works with the U.S. Agency for International Development and the Gates Foundation. "There's always been suspicion in parts of Pakistan that the polio effort is attributable to the West's interest in trying to regulate fertility, sterilize women, introduce AIDS—and lo and behold, it turns out there is possibly some sort of a link" to Western political aims.
The Abbottabad plot fits neatly into pre-existing fears. In 2007, Pakistani clerics spread rumors that Americans were trying to sterilize Muslims through polio vaccination clinics and convinced 24,000 parents not to vaccinate, causing a spike in polio deaths. Violence against the aid workers and clinics themselves was also reported.
Right now, says Thomas Cherian, coordinator of the World Health Organization's Expanded Programme on Immunization, WHO and UNICEF are trying to derail the rumor mill quickly before it gains more momentum. "Of course we are concerned about possible fallouts of such reports; these negative consequences affect not just developed countries but also industrialized countries."
A WHO official based close to the developments in Pakistan says that WHO and UNICEF officials are carefully monitoring the public reaction to the news. This includes working with Pakistani local governments to craft public health messages reassuring the public of vaccine safety and the importance of immunization (18 July, fortuitously, is National Immunization Day). "The reaction will only be about hardline elements" in certain pockets, he says, such as Pashtun extremists in Karachi. WHO and UNICEF are working particularly closely with local authorities in those places to "measure the impact" should the story reach those areas. At the same time, however, he adds that they "don't want to overreact. As far as impact on health, there are no problems as of now, we're only preparing for that eventuality."
The official, who asked not to be named, says WHO and UNICEF are devising a plan to make sure vaccination teams have proper identification—giving them proper ID cards, letters from district authorities, and jackets. Communities are being asked to ensure that anyone claiming to be a health worker identify him- or herself.
Public health workers claim to have a head start in defusing antivaccine propaganda, should any arise. After the 2007 antivaccination campaign, workers in Pakistan developed communication strategies that cut fearful rumors to a "negligible proportion," the official says.
Vaccination programs will be continuing: an official at the Khyber Pakhtunkhwa health directorate said, "It [the Guardian report] will have no impact on the immunization campaign as we have a standard procedure to carry out this exercise."
Offit, the author of a book on the antivaccine movement called Autism's False Prophets, doubts that knowledge of the conspiracy will have a major impact on people's willingness to vaccinate. When people are offered free vaccines in countries unable to afford them, he says, "the answer is a resounding, 'Yes!' " But that doesn't excuse the deception, he says: "It's a sad story. When you take something as valuable and precious and time tested as vaccines and pose them to be something else, that's awful."