Coercion has often been a dark side of the history of public health. During the campaign to eradicate small pox, there were cases of villagers in India and Bangladesh being pulled out of their homes to be vaccinated. If they ran away, they were chased down and forcibly vaccinated. This raised little outcry internationally because these were poor uneducated villagers at the bottom of the global pyramid of power and wealth. It is difficult of conceive of people in the west being forcibly vaccinated.
The same thing appears to be happening again with the polio campaign. The Daily Trust newspaper in Nigeria has reported that parents in Kebbi state in Northwestern Nigeria have been threatened with arrest, and on occassion detained until they allowed their children to be immunised.
“Arrests—detention for only hours until parents release their children for vaccination— have been a means of dealing with habitual noncompliance in parts of the state for several past rounds of vaccination, often with tacit approval from authorities and the traditional council,” the newspaper reported.
In the Democratic Repubic of Congo, UNICEF has reported that parents from all provinces except Kinshasa and Katanga have reported coercion by vaccination teams.
As international pressure grows on countries like Nigeria, Pakistan and Afganistan to eliminate the polio or risk becoming international pariahs, these governments in turn will cut corners to ensure that vaccination targets are met.
It is upto the Global Polio Programme partners- WHO, UNICEF, the US CDC, Rotary International and the Bill and Melinda Gates Foundation, as well as the Independent Monitoring Board of the polio programme to ensure that ethical, non -coercive means are used to achieve a polio free world. The means are as important as the ends.
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