Via The New York Times, an excellent article: Disease of Pakistan’s Poor Now Worries the Affluent. Excerpt:
Instability is driving the crisis. The Taliban, which had long opposed the vaccinations as part of what its leaders said was a Jewish conspiracy, has stymied immunization efforts in the northwest and the tribal belt, where infection rates are highest. The Taliban have forbidden vaccinations in North Waziristan for years, and killed vaccination teams in other areas.
Suspicions among the Taliban and others that the vaccination campaign was an espionage effort gained currency after 2011, when a covert, C.I.A.-financed vaccination campaign used to try to find Osama bin Laden came to light.
The sense of urgency that has gripped health professionals for years, however, was largely absent among the upper class, who have had limited exposure to polio. “There was a total disconnect” in society about the problem, said Dr. Anita Zaidi, a pediatric infectious diseases expert and a member of the National Immunization Technical Advisory Group.
Some of the highest refusal rates for polio vaccination were recorded in wealthy Karachi neighborhoods, where residents had little faith in public health care, Dr. Zaidi said, citing a 2011 study. Now, the vaccination requirement has drawn an ambivalent response from the wealthy.
Ibrahim Shamsi, a textile exporter who intends to travel to Canada, called it “a lot of botheration.” He said, “I’m sure I was vaccinated as a child so I don’t know why I need to do it now.”
Seher Naveed, an artist with travel plans for Berlin and Amsterdam, said she was worried that the vaccine could have an adverse effect on adults.
In Lahore, Pakistan’s second largest city, residents of the wealthy Gulberg neighborhood also expressed unease about the new requirements. Jameel Ahmed, a businessman, said he was embarrassed to have to take a vaccination at the age of 57.
A woman who gave her name as Mrs. Ahsan said the restrictions were discriminatory and unfair. “We have been singled out in the world,” she said. For some experts, the worry is that immunizing all travelers will divert scarce resources from efforts to fight polio where it is most prevalent.
Dr. Zulfiqar A. Bhutta of the Center for Excellence in Women and Child Health at Karachi’s Aga Khan University, said the W.H.O. travel advisory was “unfortunate,” and would foster an erroneous sense that polio is a universal problem in Pakistan.
“It’s not — it’s a geographic problem, and this will take the pressure off the hot spots,” he said.