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Covert Operations vs. Public Health: What is the Government Thinking?

My attention having been riveted by Ebola, I missed this startling news last week: U.S. Agency for International Development sent young people undercover to Cuba to incite anti-government activism.

This article was published in Scientific American’s former blog network and reflects the views of the author, not necessarily those of Scientific American


My attention having been riveted by Ebola, I missed this startling news last week: U.S. Agency for International Development sent young people undercover to Cuba to incite anti-government activism. Their cover was an HIV prevention workshop. This short-sighted idiocy was apparently aimed at making Cuba more “democratic,” by overthrowing Raul Castro, though that small nation is not a risk to us now. Instead, the ploy not only puts healthcare workers at risk, but will have a very harmful global public health impact.

As Congresswoman Barbara Lee, co-chair of the Congressional HIV/AIDS Caucus, noted, “This blatant deception undermines U.S. credibility abroad and endangers U.S. government supported public health programs which have saved millions of lives in recent years around the world.”

In 2011, the CIA used a fake vaccination program in Abbottabad, Pakistan, in their attempt to find Osama Bin Laden. The result? Polio vaccinations were banned by the Taliban in Afghanistan and Pakistan. More than 60 health care workers providing polio vaccines have subsequently been murdered, public distrust has surged, and polio cases are up almost two-fold since. Polio had almost been declared eradicated before this. Now WHO is worried that polio will again emerge as a global health concern, despite being tantalizingly close to eradication, after having spent more than $10 billion trying.


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Wikileaks reveals that USAID has been involved in attempts to overthrow Hugo Chavez in Venezuela in 2002. Bolivia also then expelled USAID.

We’ve seen the same mistrust lead to vaccine refusals in the Muslim regions of Nigeria, fearing the drugs were contaminated with anti-fertility drugs or HIV.

The State Department reportedly supported the USAID ploy, although the Obama administration had banned the use of fake vaccination programs after the fallout from the CIA debacle. That was apparently a question of semantics, rather than a blanket prohibition of using public health programs as a ruse.

And now we are seeing mistrust fueling attacks on healthcare workers fighting Ebola and forcing humanitarian groups like Doctors Without Borders to close operations in some areas.

In contrast, the worldwide epidemic of SARS in 2003 was contained by unprecedented multinational cooperation and careful infection control. This should be the model we aspire to attain for Ebola and future outbreaks.

Did US government leaders not learn anything from the polio outbreaks that followed the CIA’s use of public health workers as government agents in Pakistan? It should have been abundantly clear then, if it wasn’t before, that public health threats endanger us all. Infectious disease epidemics should be a global concern, above politics. These communicable diseases are a far greater threat to the US than many other security issues. That trust in public health is being jeopardized for such paltry gains is absurd. What were these narrow-focused “strategists” thinking?

 

Credits:

USAID poster with graffiti - David Lisbona/Flickr

Polio map - modified from Tobus [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons

"Molecules to Medicine" banner © Michele Banks

Judy Stone, MD is an infectious disease specialist, experienced in conducting clinical research. She is the author of Conducting Clinical Research, the essential guide to the topic. She survived 25 years in solo practice in rural Cumberland, Maryland, and is now broadening her horizons. She particularly loves writing about ethical issues, and tilting at windmills in her advocacy for social justice. As part of her overall desire to save the world when she grows up, she has become especially interested in neglected tropical diseases. When not slaving over hot patients, she can be found playing with photography, friends' dogs, or in her garden. Follow on Twitter @drjudystone or on her website.

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