1. Global Public Health and National Autonomy
In 1988, when polio was endemic in 125 countries, the annual world assembly of health ministers in Geneva declared their goal of eradicating it by 2000. That target was missed, but a $3 billion campaign had it contained to only six countries (Nigeria, Niger, Egypt, Pakistan, Afghanistan and India) by early 2003 (1).
When recently a case of polio was detected in Indonesia, the WHO officials pin-pointed Nigeria as being the source. They indicated how an outbreak had spread from northern Nigeria since 2003 and had crossed the ocean to reach Indonesia: the world’s fourth most populous country. Their explanations of how it got there are that it was either brought back by an Indonesian working in Saudi Arabia or by a pilgrim who went to Mecca.
Resistance to polio vaccine has been high from northern Nigeria to the Pakistan frontier because of persistent rumors that it is a Western plot to render Muslims infertile or to spread AIDS. Ironically, after several states in Muslim northern Nigeria halted vaccinations in 2003, it was purchases of Indonesian vaccine that persuaded wary imams and politicians to drop their opposition, because Indonesia is a Muslim country.
Questions:
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What responsibility do national governments have to global health promotion?
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Why have international health interventions historically sometimes been locally perceived as attempts to attack populations by reducing their fertility or even thought of as a covert plot towards population extinction?
References:
(1) Extract from African Strain of Polio Virus Hits Indonesia, by DONALD G. McNEIL Jr, published: May 3, 2005, New York Times (http://www.nytimes.com/2005/05/03/international/03virus.html?_r=0)
