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Health

Taliban Calls Off Attacks On Polio Vaccine Workers In Afghanistan

(Photo: Afghan child receives polio vaccine, Credit: UNICEF)

In a change of tactics, the Taliban has called off its attacks against health workers in Afghanistan, providing space for polio workers to finally eradicate the deadly disease.

The former leaders of Afghanistan have gone back and forth on allowing aid workers to administer the polio vaccine to Afghan children over the years. Last year, the group decided to allow the program to go forward so long as workers “not use government resources, including vehicles and soldiers, and they should use their own resources so that they impartially execute their program.” At the time, their spokesperson also claimed that the Taliban has always supported vaccinations.

That commitment was questioned yet again this year, when in March the Taliban halted the program in Afghanistan’s Nuristan province. “For the past three years Waygal district has been under the Taliban, they are very strong there. For the last two years the vaccine process went on in the district, but this year they stopped it,” Nuristan governor Tamim Nuristani told the Guardian at the time.

It seems, however, that the Talibs have had a change of heart once more. In a statement issued from “The Islamic Emirate of Afghanistan” — the country’s full name when under Taliban rule — the vaccination push has been given the all-clear:

“According to the latest international medicine science, the polio disease can only be cured by preventive measures ie the anti-polio drops and the vaccination of children against this disease.

“The Islamic Emirate of Afghanistan supports and lends a hand to all those programs which works for the health care of the helpless people of our country,” said a statement issued by the ‘Islamic Emirate of Afghanistan’.

But it warned the World Health Organisation and Unicef to employ only “unbiased people” in a campaign “harmonised with the regional conditions, Islamic values and local cultural traditions.”

It also ordered its fighters to give polio workers “all necessary support”.

Afghanistan is one of only three countries — alongside Nigeria and Pakistan — where polio is still endemic. Last year, the country had thirty-six new cases of polio, with an estimated 160,000 to 180,000 children missing their scheduled vaccinations. In April, the Afghan government pledged to administer anti-polio and anti-measles vaccines to eight million Afghan children under the age of five this year.

And while the Taliban’s pledge to allow aid workers to complete their work is promising, it leaves questions remaining for the other two countries seeking to eradicate polio, both of which have also experienced numerous attacks on aid workers. In Nigeria, home of the most polio outbreaks in the world, the extremist group Boko Haram killed at least nine aid workers in February. Likewise, in Pakistan at least a dozen aid workers have been killed since the start of the year.

Health

Health Workers Gunned Down In Nigeria, Threatening Global Effort To Combat Polio

Child receives polio vaccine in Nigeria

Several health workers administering vaccines were shot dead in Nigeria today, part of a spread in violence threatening the tantalizingly close eradication of polio.

While the exact number of those dead is unclear — estimates on the ground vary from as many as twelve to as few as nine — there is a consensus growing about the identity of the group behind the attack:

No one claimed responsibility but the Islamist militant group Boko Haram, which has condemned the use of western medicine, has been blamed for a spate of assaults on security forces in the city in recent weeks.

[...]

“Gunmen opened fire on a health centre in the Hotoro district, killing seven, while an attack on the Zaria Road area of the city claimed two lives,” said a police spokesman, Magaji Musa. “[The health workers] were working for the state government giving out polio vaccinations at the time of the attack.”

Boko Haram — which has referred to itself as the “Nigerian Taliban” — has been a thorn in the side of the Nigerian government for over a year now, launching attacks against government facilities and bombing multiple churches. Should they be behind today’s murders, it would be the first instance of their targeting health workers.

The attacks seem close in nature to a rash of killings that swept through Pakistan last month, killing over a dozen. Much as in that case, current reports indicate all of those killed in Nigeria on Friday were women. Unlike in Pakistan, however, there’s no CIA program to blame the workers for colluding with. Instead, the militants have blamed the vaccines for being a Western plot to sterilize young girls and causing AIDS, neither of which is remotely true.

Nigeria is one of the last remaining holdouts of polio on Earth, with only Pakistan and Afghanistan joining it in having regular significant outbreaks. In 2012, Nigeria had at least 121 cases of polio, by far the most in the world. Facilitating a drop in those numbers will require a near universal vaccination rate, one that is unlikely to occur with the threat of violence.

Security

Former Obama Official Defends Drone Program, Calls For More Transparency

Former DNI Dennis Blair

Former Director of National Intelligence Adm. Dennis Blair (ret.) today defended the role of drones in the United States’ foreign policy toolkit, before calling for greater transparency in the programs that utilize them.

Speaking on a Council on Foreign Relations conference call with scholar Michael Zenko — who recently published a report on reforming drones’ use — Blair said that drones should be thought of as “long-range snipers, in the military sense.” Despite his support, he recognized the limitations. “I’m not as much a believer that drones are ‘wonder weapons’ as other people,” Blair made clear.

More concerning to both Zenko and Blair was the way in which the use of unmanned aerial vehicles — the technical name for drones — goes unexplained to the public and that the justification for their role in targeted killing is tightly held. That combination negatively impacts the U.S. mission in the countries it is trying to impact, Zenko argued. “Drones are the face of U.S. foreign policy” in Pakistan and Yemen, he said. “We allow the Taliban, and the Pakistani [intelligence agency], to tell the story of how our drones are being used.”

The majority of criticism of the Obama administration’s drone program from Zenko and Blair centered on the targeted killing component. On Sunday, the Washington Post reported that a new “playbook” is being developed to codify the ways in which targeted killings are decided upon and conducted:

Among the subjects covered in the playbook are the process for adding names to kill lists, the legal principles that govern when U.S. citizens can be targeted overseas and the sequence of approvals required when the CIA or U.S. military conducts drone strikes outside war zones.

U.S. officials said the effort to draft the playbook was nearly derailed late last year by disagreements among the State Department, the CIA and the Pentagon on the criteria for lethal strikes and other issues. Granting the CIA a temporary exemption for its Pakistan operations was described as a compromise that allowed officials to move forward with other parts of the playbook.

While Zenko and Blair both welcomed the playbook concept in theory, they both had their reservations about the scope of the document. “A classified ‘playbook’ does not reassure the American people, who I think are the primary ones that need to be convinced that their government is doing the right thing,” said Blair. Zenko in turn called a playbook that did not cover Pakistan at all “useless,” as 85 percent of targeted killings in non-battlefield areas have taken place in Pakistan.

Asked about the split between drone programs operated by the Department of Defense and the Central Intelligence Agency, Blair said that he strongly believes a great majority of the use of drones should be used by military forces. At present, the Defense Department operates armed drones openly, using them for strikes in areas such as Yemen. These strikes are included in reports to Congress under the War Powers Act, leaving a paper trail for their use.

The CIA run program in Pakistan falls under aims to be covert, with the entire program classified. This distinction, Blair said, allows Pakistan to have the best of all worlds on the program, allowing the United States to take care of shared militant threats while vehemently denouncing the United States.

What Blair’s looking for isn’t greater review of the program, though. There’s plenty of that, he said, as there are internal review methods within the Executive Branch, as well as reports to Congress from both Defense and the CIA regarding the programs. What’s needed instead is more transparency and investigation into the programs. The goal, according to Blair: “Remove not the secrecy, but the mystery of these things.” Blair’s thinking coincides with several major newspapers who are suing for greater transparency, as well as former Pentagon lawyer Jeh Johnson.

Security

Panetta Signals Scaled Back Drone Program

Outgoing Defense Secretary Leon Panetta can see a world in which the use of drones is no longer a staple in the United States’ counterterrorism toolkit, according to an interview with ABC News.

In a wide-ranging interview with ABC’s Martha Raddatz, Panetta spoke on topics including Afghanistan, Syria, and the current crisis in Mali. When asked about whether he believes American civilians should know more about the use of drones by the Central Intelligence Agency, Panetta demurred. “I wish frankly that Americans you know, could really see what I’ve seen as director of the C.I.A. and now as Secretary of Defense in terms of our use of operations to go after those that have attacked our country,” Panetta said.

Panetta went on to defend the use of drones in going after Al Qaeda, while also leaving an opening for their eventual retirement as a cornerstone of that strategy:

PANETTA: And a key part of that has obviously been the use of the operations involving the drones that target those that are in the leadership in Al Qaeda. And that’s a reality. We’ve decimated their leadership as a result of those operations. So you know, my view of it is, you know, it’s not something that we’re going to have to continue to use forever. But it’s a very effective tool, it’s a very effective weapon at going after those who are enemies of the United States of America.

Watch the interview here:

Panetta’s statements echo those made by outgoing Pentagon lawyer Jeh Johnson, who has previously said that the so-called war on terror “shouldn’t be regarded as a perpetual war without any sort of end.” While Johnson’s comments earlier this month were based on a speech delivered in November at Oxford, they were expanded upon only after he left office. Panetta’s interview may come while he is heading for the exit, but he remains in charge of the Pentagon for the time being.

For now, though, the use of unmanned aerial vehicles — as drones are formally known — continues unabated, with a surge of strikes within Pakistan so far in 2013. Those numbers have not been acknlowedged by the U.S. government, however, as the CIA’s program remains classified. The secrecy surrounding the program was shown in Panetta’s notable lack of a response during the interview to Raddatz’s question, the continuation of a policy that lead to several major newspapers calling for more transparency. Even unarmed drones aren’t without their own controversy, exemplified in reaction to the announcement last week a fleet of surveillance drones are being sold to Afghanistan for use after the US ends its combat mission in 2014.

Health

Top Public Health Schools Condemn CIA For Thwarting Disease Prevention In Pakistan

Child receiving measles vaccine in Pakistan (Photo credit: Measles Initiative)

Twelve of the deans leading the nation’s top public health schools have written to President Barack Obama to condemn the use of public health programs as cover for covert activities.

In 2011, it was reported that the Central Intelligence Agency utilized a vaccination program as cover to confirm the whereabouts of Osama bin Ladin in Abottabad, Pakistan. Since then, health workers have been targeted for violence throughout the country, with over a dozen murdered in the past three weeks alone. The upswing in violence caused the United Nations to suspend their vaccine work in December, while the covert operation itself led the Pakistani government to kick out the NGO Save the Children in Sept. 2012.

In the course of the one-page letter, the deans or such schools as Harvard, Johns Hopkins, and UCLA take the President and the administration to task for their role in the spreading mistrust of health workers, and close with an impassioned plea to prevent further uses of health programs for intelligence-gathering:

Independent of the Geneva Conventions of 1949, contaminating humanitarian and public health programs with covert activities threatens the present participants and future potential of much of what we undertake internationally to improve health and provide humanitarian assistance. As public health academic leaders, we hereby urge you to assure the public that this type of practice will not be repeated.

International public health work builds peace and is one of the most constructive means by which our past, present, and future public health students can pursue a life of fulfillment and service. Please do not allow that outlet of common good to be closed to them because of political and/or security interests that ignore the type of unintended negative public health impacts we are witnessing in Pakistan.

The letter specifically refers to a recent spike in treatable diseases run rampant in Pakistan, following the surge in suspicion towards vaccination programs and the workers who administer them. In particular, have measles have jumped from 4,000 in 2011 to 14,000 in 2012. Likewise, Pakistan is one of only three countries where polio remains endemic, a statistic that will be unlikely to change should attacks on health workers continue.

Security

In Huge Shift, Pakistan Recognizes Militants As Top Threat

Under a new military doctrine, Pakistan has now officially recognized that “homegrown militancy” is the top threat that the country faces, replacing neighboring India for the first time.

For decades, it has been an unofficial policy of Pakistan to cultivate ties with militant groups for use as proxies in battles against external enemies. These groups could be used in either direction across Pakistan’s border, to the west towards Afghanistan or to the east towards India. Among these, the Haqqani Network remains the perpetrator of some of the most deadliest attacks within Afghanistan, with Pakistan viewing the organization as a hedge towards retaining influence in the state as the United States prepares for a drawdown and eventual exit.

Likewise, the deadly coordinated Mumbai attacks of 2008, in which gunmen killed over 164 in a single day in India’s largest city, was conducted by terrorists on the order of and with assistance from Pakistan. In recent years, however, Pakistan has found itself plagued by similar terrorist organizations, including the Pakistani Taliban, which is recently responsible for shooting a young girl named Malala Yousafzai. For the Pakistani Army — which often exercises control of the state either through periodic coups or the so-called “deep state” — to label militants as the primary threat that the state faces is a momentous shift.

Despite this, the army attempted to play down the importance of the change in policy:

“Army prepares for all forms of threats. Sub-conventional threat is a reality and is a part of a threat matrix faced by our country. But it doesn’t mean that the conventional threat has receded,” Maj-Gen Asim Saleem Bajwa, the director general of the Inter-Services Public Relations (ISPR) told The Express Tribune.

According to the BBC, the new Army Doctrine talks about unidentified militant groups and their role to create unrest in the country. It also mentions that Pakistani militants have found refuge across the Durand Line in Afghanistan.

Since the partition of 1947, Pakistani leaders have believed that India posed the country’s greatest existential threat. The perceived threat was exacerbated by tensions over control of territory in the state of Kashmir, which was the cause of three of the four wars that the states have fought. While the new doctrine does not negate the premise that India is a threat, its downgrading could be the key to a lasting upgrade in relations between the two.

In the same way, tensions between the United States and Pakistan have often been the result of the latter’s ties to groups operating in Afghanistan from bases in Pakistan. The radio silence between the two during the raid that resulted in the death of Osama bin Laden was due to the belief within the United States that someone within Pakistan’s military with ties to militants would leak details of the attack. As a result, the raid caused a deep chill in U.S.-Pakistani relations.

Health

Treatable Diseases Are Surging In Pakistan As Aid Workers Continue To Be Attacked

Pakistani girl receives vaccination

Preventable diseases like measles and polio are on the upswing in Pakistan after years of decline, mainly due to growing wariness of vaccines — or, more specifically, wariness of the programs and people that administer those vaccines.

In a continuation of violence in December that saw the murder of six aid workers on the streets of Pakistan’s cities, another seven civilians have been killed since the start of 2013. All but one of those killed on Jan. 1 were female, continuing a disturbing trend of gender disparity in those targeted. All seven of the most recent victims, five teachers and two health providers, were Pakistani nationals working at a community center providing health and education services in remote northern Pakistan.

These attacks are taking a toll on the health and well-being of Pakistan’s children, with easily treatable diseases making a pronounced comeback. Measles in particular has seen an amazing surge. According to the World Health (WHO) the number of measles cases in Pakistan has surged from 4,000 in 2011 to 14,000 in 2012. 306 died of the disease in 2012, compared to only 64 in 2011. The increase has prompted the WHO to launch an emergency vaccination campaign in the Sindh state, where the outbreak has been particularly severe.

In an interview with al Jazeera, Dr. Zulfiqar Ahmed Bhutta, a child health expert said that the outbreak could have easily been foreseen:

“This was a tragedy that was waiting to happen. We have been predicting for a while now that without adequate cover with routine immunisation in many parts of Pakistan, notably in rural populations, that there was bound to be a situation where you would have an outbreak like this …. So what we are seeing this year is an absolute reflection of dropping the ball in covering an adequate cohort of children in rural and poor populations of Pakistan, particularly in the south, against a completely preventable disorder like measles.

A large part of the opposition to vaccine campaigns can be traced back to the United States’ decision to use one as cover for obtaining proof that Osama bin Laden was living within the Pakistani city of Abottabod. In the months and years since, aid workers in Pakistan have faced growing violence while attempting to inoculate those most vulnerable from diseases that have long since been wiped out in other countries.

Health

How The CIA May Have Undermined Polio Treatment In Pakistan

Child receiving polio drops in Pakistan

On Tuesday, a coordinated attack in Pakistan left four female health workers dead on the streets of Karachi, a major port city. In the city of Peshawar, another two aid workers were gunned down. And on Wednesday, another two people were killed and another was wounded in Peshawar — leaving many wondering if a program spearheaded by the Central Intelligence Agency to capture Osama bin Laden could be a contributing factor in all the violence.

The four workers killed in Karachi were all part of a program by the Pakistani government to vaccinate children against polio. Pakistan is one of the last countries where polio remains endemic, and a conference that opened on Wednesday was meant to highlight the country’s successes in combating the diseases over the past year. Cases dropped from a staggering 173 in 2011 to only 56 so far in 2012, in large part due to a huge public health effort from the government, international organizations, and non-governmental organizations.

That progress is now at risk, as the United Nations announced that World Health Organization and UNICEF employees on the ground in Pakistan were suspending their work due to the current violence. No group has officially taken credit for the attacks, but police have said that at least two of the incidents in Peshawar were carried out by members of the Pakistani Taliban. While officially having denied involvement, the Pakistani Taliban has been outspoken about their dislike of the Western-backed vaccination program.

Part of the Taliban’s opposition is due to the controversial way that the CIA sought intelligence on bin Laden’s presence in the Pakistani city of Abbotabad. In 2011, the Guardian revealed details about the CIA’s use of a fake vaccination program to collect “DNA from any of the Bin Laden children in the compound [which] could be compared with a sample from his sister, who died in Boston in 2010, to provide evidence that the family was present.” Pakistani doctor Shakil Afridi was jailed by the government earlier this year on charges of treason for his part in the deception.

In 2011, shortly after details of the ruse became clear, global health blogger Chris Albon noted the potential backlash that could result from the CIA program:

Insecurity has a serious negative effect on health care in rural communities. The greater the personal risks, the greater the appeal for both national and international health workers to stay within the safety of major cities, venturing out only in large convoys. This so-called “bunkerization” diminishes the ability of health campaigns to target rural communities — often those most in need of primary health care. The best way to overcome bunkerization is through building relationships with communities and local elites, allowing for the free movement of health workers in a region — exactly the kind of thing undermined by the CIA’s apparent operation.

And that’s what appears to be playing out now in Pakistan. While the DNA obtained in the CIA’s covert operation did in fact help prove that bin Laden was present, the effects of the CIA’s actions may have hindered the legitimate polio vaccination program in the country.

Security

Suddenly Centrist Romney Repeatedly Praises Obama’s Foreign Policy In Debate


If you didn’t know better, you would think at times in the third and final debate that Governor Mitt Romney was actually an Obama campaign surrogate. For someone who once said, “This is the first time we’ve had a president that doesn’t have a foreign policy,” Romney agreed in part or in totality with an astonishing number of the President’s policies.

“I don’t blame the administration for the fact that the relationship with Pakistan is strained,” Romney said, later adding that “the president was right to up the usage” of drones.

From Iran to Afghanistan to China, Romney attempted to swing to a much more moderate position on many of the foreign policies under debate and in doing so, put himself in conflict with his previous statements:

AL QAEDA

ROMNEY NOW: We’re going to have to recognize that we have to do as the president has done. I congratulate him on taking out Osama bin Laden and going after the leadership in al-Qaeda.

ROMNEY THEN: “I do not concur in the words of Barack Obama in a plan to enter an ally of ours [Pakistan]” to get bin Laden. [8/06/2007]

IRAN

ROMNEY NOW: I laid out seven steps, crippling sanctions were number one. And they do work. You’re seeing it right now in the economy. It’s absolutely the right thing to do, to have crippling sanctions. I would have put them in place earlier. But it’s good that we have them.

ROMNEY THEN: But nothing in my view is as serious a failure as [President Obama's] failure to deal with Iran appropriately. This president — this president should have put in place crippling sanctions against Iran, he did not. [02/22/2012]

AFGHANISTAN

ROMNEY NOW: We’ve seen progress over the past several years. The surge has been successful and the training program is proceeding apace. There are now a large number of Afghan Security Forces, 350,000 that are ready to step in to provide security and we’re going to be able to make that transition by the end of 2014.

ROMNEY THEN: I stand with the commanders in this regard and have no information that suggests that pulling our troops out faster than that would do anything but put at — at great peril the extraordinary sacrifice that’s been made. This is not time for America to cut and run. [11/22/2011]

CHINA

ROMNEY NOW: We can be a partner with China. We don’t have to be an adversary in any way, shape or form. We can work with them, we can collaborate with them, if they’re willing to be responsible.

ROMNEY THEN: [W]e should not fail to recognize that a China that is a prosperous tyranny will increasingly pose problems for us, for its neighbors, and for the entire world. [2/16/12]

During last night’s debate, Romney “had little coherent to say and often sounded completely lost,” a New York Times editorial noted this morning. “That’s because he has no original ideas of substance on most world issues. … Mr. Romney’s problem is that he does not actually have any real ideas on foreign policy beyond what President Obama has already done, or plans to do.”

Update

CAP’s Matt Duss writes: “Despite Romney’s momentary embrace of President Obama’s policies, we should still be concerned with the role that neoconservatives would play in a Romney administration.”

Update

The Huffington Post put together a video montage of all the moments Romney agreed with the President’s foreign policy:



Alyssa

‘Zero Dark Thirty’ And The Rise of Female Spies

I’m unsure about the voiceover used to sell the movie, but I remain pretty excited for Zero Dark Thirty, in part because of its focus on the role of female intelligence operatives. I’d have a proclivity for these kinds of stories in the first place, and it doesn’t hurt that, as Eli Lake recently recounted in a great feature for Newsweek on women and espionage, is actually an accurate reflection of how the hunt for bin Laden went down:

The most human moment in the trailer may be Chris Pratt asking Joel Edgerton “What part convinced you?” and Edgerton’s deadpan response, “Her confidence.” It’s a relatively new thing, this idea that we could trust women to give orders to men in uniform, and all of a sudden, we’ve got a lot of fascinating female intelligence operatives playing with that tension and those questions about reliability. In the current iteration of the James Bond movies, M stands for mother, to a certain extent, with Bond breaking into her apartment and playing fast and loose with her orders in a classic display of rebellious boundary-testing. On Homeland, Carrie Mathison is meant to seem unreliable because of her mental illness and the way it interacts with her gender, influencing her affairs with both David Estes, her boss, and Nicholas Brody, her target. But the show doubles up the reasons she shouldn’t be trusted, and then proves her right anyway. Now, Jessica Chastain, who doesn’t actually speak a word in this trailer, presented in profile, eyes huge or utterly obscured, is being presented as the person on whose shoulders the mission to get Osama bin Laden rested. That cleaving of the requirement that expertise be validated by machoness if not explicitly by gender, even by emotional stoicism, is fascinating and important. These are big, tense, horrible things the intelligence community sets into motion. And women seem to be the ones expressing the weight of that knowledge, and those decisions.

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