For Parents in Pakistan, It's Vaccinate or Face Jail

Hundreds of parents have been arrested in Pakistan for refusing their children's polio vaccinations after an immunization drive was launched Monday in the northwestern province of Khyber Pakhtunkhwa to vaccinate 2.7 million children.

A spokesman for the district administration in Peshawar, the province's capital, told the Associated Press that 471 people had been arrested.

"There is no mercy, we have decided to deal with the refusal cases with iron hands," Riaz Khan Mehsud, deputy commissioner of Peshawar, told the AFP. "Anyone who refuses [the vaccine] will be sent to jail." Parents were arrested under a law against endangering public safety, the AP reports.

Pakistan reported the vast majority of the world's polio cases in 2014, with 306 of the 342 recorded, according to the World Health Organization. It is one of only three countries where polio was still endemic in 2014 (along with Afghanistan and Nigeria), and has reported 13 cases so far this year. Worldwide polio numbers have seen a drastic decrease since 1988, when roughly 350,000 cases were reported.

One of the major barriers to immunization in Pakistan is the Taliban, which banned polio vaccinations in 2012 in the areas it controls, North Waziristan and South Waziristan. The ban came after the CIA reportedly used a fake vaccination drive to get DNA from the terrorist Osama Bin Laden's family, according to a Guardian investigation published in 2011. Though that drive was for hepatitis immunization, Taliban militants claim that the polio efforts are a front for spies or a ruse to sterilize Muslims.

Since instituting the ban, the militants have killed dozens of health workers who distribute the polio vaccine in Pakistan. But rumors such as those about sterilization and others that claim the vaccine causes AIDS also circulate outside of Taliban-controlled areas, and attacks are not limited to those areas.

"It's a cultural issue," Dr. Padmini Murthy, an Indian-American professor who teaches public health practice at New York Medical College, says of rumors involving infertility that she has encountered in India as well. "Parents are scared because they don't know what the vaccine is, what are the effects it has," she explains. "What if a girl becomes infertile? This is one of the biggest worries I think."

In some parts of the world like Southeast Asia, she says, the vaccines—made in labs in the U.S. and other Western countries—are seen as an "intrusion upon their culture."

Religious scholars have come out to insist there is no link between the vaccine and infertility, Murthy says, but like the belief in an MMR-autism link that persists in the U.S. despite years of refutations and evidence to the contrary, the rumors continue to sway some parents.

In November, Pakistan's prime minister, Nawaz Sharif, "declared war on polio," his aide Musadik Malik told reporters. "We are committed irrespective of the hardship, irrespective of the challenge." The declaration came after the Independent Monitoring Board of the Global Polio Eradication Initiative criticized Pakistan's campaign to eradicate polio in a scathing report:

Pakistan's polio programme is a disaster. It continues to flounder hopelessly, as its virus flourishes. Home to 80% of the world's polio cases in 2014, Pakistan is now the major stumbling block to global polio eradication. The principal victims are the children of Pakistan, who are left vulnerable and unprotected by their government.

Muhammad Mumtaz, a senior official of Peshawar, told the AFP that the parents arrested would "be freed only after a written assurance and providing two guarantors" stating that their children would receive the vaccine, which is administered there as an oral drop.

Murthy says she is surprised to hear of the arrests, which have happened before but rarely on this scale. She is hoping polio will be fully eradicated, she says, but it remains to be seen whether "these kind of very stringent interventions have a positive or a negative impact."