On May 2nd, 2011, the most hunted man in the world met his end. Bullets fired by U.S commandos finally sealed the fate of Osama Bin Laden 5. As the news spread people in the United States poured into the streets celebrating the death of America’s decade-old public enemy. Years of intelligence gathering and battles had finally paid off; it was a victory during the war on terror. But initially, little thought was put forth of the consequence of this action. The sovereignty of Pakistan, an American ally, was violated, and the means of finally getting Bin Laden were later found to be more malevolent than at first thought. To finally pin down Bin Laden, the United States endangered global health efforts that it was involved in. Putting forth the question, why does the U.S so wontly endanger global health?

Currently, Pakistan is the one three countries still affected by polio 8. Due to poor health infrastructure and difficult terrain, efforts to eradicate the disease have faced challenges. Furthermore, at the time of the raid, there was a misinformation campaign spearheaded by the Taliban to discourage vaccinations 4. The militants claimed that vaccinations would lead to sterilization, that the ingredients included alcohol or pig’s fat, or that the vaccination programs were just a spying program set up by the West 5. Before the assassination of Bin Laden, these rumors were starting to die down 4. However, the latter claim in a twist of fate was real, and it would damage vaccination efforts for years to come.

A report by National Geographic would later piece together how the espionage operation started. Shakil Afridi, a Pakistani Doctor, was approached by representatives of Save the Children, an American NGO (non-governmental organization), to provide details about his kidnapping by militants a year earlier 5. However, The Pakistani government would later claim that Dr. Afridi was recruited by the CIA at this seminar 5. Save the Children was at the time was coordinating with USAID (The United States Agency for International Development), as well as, receiving funding from the agency 5. Two years later Dr. Afridi was given a mission. To start a vaccination campaign that would collect blood for DNA analysis. He was not told what the real objective of the operation is. He met with his handlers at USAID warehouses and was hidden while being transported there to ensure no one knows he was there 5. He started his first round of vaccinations for the Hepatitis B in the town of Abbottabad 5. As his vaccination campaign went forward, he went to the neighborhood of Bilal Town, where his main targets were 5.

The CIA had received intelligence that a high ranking Al Qaeda operative was living in a compound in Bilal Town, Osama Bin Laden 5. The CIA wanted to confirm that he was there, hoping to avoid mistakes of the past. If they were just to bomb the compound, there would be no way to confirm that he was dead. Hopefully, if Dr. Afridi was to get blood from Bin Laden’s extended family in the compound, they could confirm that he was in there. Already the U.S had one sample of blood from one of Bin Laden’s relatives who had died in the U.S 5. However, the plan had its flaw. The neighborhood Bin Laden was living in was rich. Why would vaccination workers come there since they normally serve the poor? Furthermore, Dr. Afridi and his nurses could not access the compound and were turned away. Yet, they did get one piece of important intelligence, a phone number for an important Al Qaeda courier. This information was useful for later getting Bin Laden. Dr. Afridi abandoned the vaccination campaign, failing to supply the vital two other rounds of vaccinations for Hepatitis B. This failure would later come back to haunt everyone involved.

After the story broke in the British newspaper The Guardian, Dr. Afridi was promptly captured and jailed by the Pakistani government 7. For whatever reason, the CIA had failed to get him out of the country 5. He was allegedly tortured by the ISI (Inter Service Intelligence) and was later sentenced to 33 years in jail, despite U.S efforts to get him out 2. The effects of the news breaking were disastrous. Fears of vaccination were rekindled throughout the country. Militants started a campaign to assassinate vaccine workers; killing 63 within a two-year period. Save The Children was promptly kicked out Pakistan 3,5. Years of progress and millions of dollars of aid were now for naught.  

U.S. Air Force Staff Sgt. Bianca Raleigh, 31st Medical Operations Squadron allergy and immunizations noncommissioned officer in charge, administers a patient’s shot March 23, 2015, at Aviano Air Base, Italy. In addition to providing patients with required vaccinations, the immunization clinic offers allergy shots and air allergen skin testing. (U.S. Air Force photo by Senior Airman Areca T. Wilson/Released)

In a letter criticizing the operation 12 deans of the top public health schools, including Johns Hopkins, asserted that part of the moral failure of the CIA was ignoring the need for “medical neutrality” 9 outlined by both the U.N and the Geneva convention. Without this neutrality, the access afforded to humanitarian workers to global hotspots would be impossible. Yet there was an even deeper violation that occurred. The essential Hippocratic tenets, “do no harm” was discarded. The organizations behind the plot ignored these moral guidelines. Though save the children was a NGO they certainly were influenced by the U.S government, since they received much of their funding through them. This level of influence may have corrupted the aims of Save the Children. Even if they were not part of the operation, which is a distinct possibility since the CIA is not allowed to infiltrate NGOs, there remains a great moral quandary. Despite being part of the push to promote public health, the U.S agencies involved found themselves at odds with each other. Furthermore, if Save the Children were complicit there are even more worrying implications.  A state’s view of morality often is one more flexible; actions are to serve the state, not necessarily the public or the world at large. To the CIA officers handling this operation were concerned with national security, not vaccinations. However, USAID was supposed to act as a tool of soft power, to show the U.S cared about the world. Both agencies goals clashed, and ultimately the CIA derailed the USAID efforts by perhaps using Save the Children as a pawn.

This operation serves as a worrying reminder about NGO’s that help with global health. They serve as soft power for the states and thus are an extension of the state. After the letter was published the Obama administration pledged never to use vaccination based espionage operations ever again1, but this commitment does not necessarily protect against other uses of NGOs for espionage. Thus, we need to reconsider how we view NGOs which are involved in public health. To what degree do they work with the government, how could a government leverage their influence to their own ends, and most importantly how could this affect public health. As of now polio still exist in Pakistan and it eradication may still take many more years. Worse of all is that the lives of innocents with the best of intentions were taken over because of paranoia over vaccines.


  1. Bentz, L. (2014, May 20). CIA policy: Won’t use vaccination programs as part of operations CNNPolitics. Retrieved September 24, 2017, from http://www.cnn.com/2014/05/19/politics/cia-vaccination/index.html
  2. Boone, J. (2012, May 23). Doctor who helped US in search for Osama Bin Laden jailed for 33 years. Retrieved September 24, 2017, from https://www.theguardian.com/world/2012/may/23/doctor-bin-laden-cia-jail
  3. McGirk, Tim. “Taliban Assassins Target Pakistan’s Polio Vaccinators.” National Geographic, National Geographic Society, 18 May 2016, from news.nationalgeographic.com/2015/03/150303-polio-pakistan-islamic-state-refugees-vaccination-health/
  4. Pakistan polio: Seven killed in anti-vaccination attack. (2016, April 20). Retrieved September 24, 2017, from http://www.bbc.com/news/world-asia-36090891
  5. Mullaney, A., & Hassan, S. A. (2016, August 11). He Led the CIA to bin Laden-and Unwittingly Fueled a Vaccine Backlash. Retrieved September 24, 2017, from http://news.nationalgeographic.com/2015/02/150227-polio-pakistan-vaccination-taliban-osama-bin-laden/
  6. Robison, P. (2014, May 21). The CIA Stops Fake Vaccinations as Real Polio Rebounds. Retrieved September 24, 2017, from https://www.bloomberg.com/news/articles/2014-05-21/the-cia-stops-fake-vaccinations-as-real-polio-rebounds
  7. Shah, S. (2011, July 11). CIA organised fake vaccination drive to get Osama bin Laden’s family DNA. Retrieved September 24, 2017, from https://www.theguardian.com/world/2011/jul/11/cia-fake-vaccinations-osama-bin-ladens-dna
  8. Summary of poliovirus circulation in 2016 – Pakistan. (n.d.). Retrieved September 24, 2017, from http://www.who.int/csr/don/27-december-2016-polio-pakistan/en/
  9. Wood-Wright, N., & JH Bloomberg School of Public Health. (2015, June 24). CIA Vaccination Cover in Pakistan. Retrieved September 24, 2017, from https://www.jhsph.edu/news/news-releases/2013/klag-CIA-vaccination-cover-pakistan.html
  10. http://polioeradication.org/where-we-work/pakistan/
  11. http://www.who.int/mediacentre/news/statements/2017/14th-ihr-polio/en/
  12. Images

    Header Image
    Description: A Somali boy receives a polio vaccination at the Tunisian hospital in Mogadishu. The hospital treats local diseases, malnutrition, and other injuries.
    Date: 25 December 1993
    Source: http://www.defenseimagery.mil/assetDetails.action?guid=67a9f3f05385b5e0985fd2ae8eea1fcf9c9f98a2
    Author: PV2 Andrew W. McGalliard
    This work is in the public domain in the United States because it is a work prepared by an officer or employee of the United States Government as part of that person’s official duties under the terms of Title 17, Chapter 1, Section 105 of the US Code. See Copyright.

Posted by Elquis Castillo

Elquis is a freshman studying Biology. As part of the
creative team he takes photographs in addition to writing articles.