Recent findings suggest a relationship between conflicts resulting from Islamist insurgency and the incidence of poliomyelitis in the Middle East.
“Ours is the first study to use cross-national statistics to show that Islamist insurgency has a strong influence on where polio occurs — but, interestingly, only in the last few years,” Jonathan Kennedy, PhD, of the political science department of University College London, said in a press release. “As the core tenets of Islam have not changed over the period of the study, this isn’t a result of insurgents’ theology. Rather, it seems to be a reaction to the counterinsurgency strategies used against Islamist insurgents.”
Previously studies have found that the presence of conflict often hampers public health efforts, the researchers wrote, due to the disruption of resources intended for health care, forced migration and, in recent cases, the deliberate undermining of polio immunization campaigns. To investigate this effect in the context of ongoing Islamist insurgency, Kennedy and colleagues examined data from the Uppsala Conflict Data Programme Armed Conflict Dataset, which defines active conflicts as those between state and opposition groups resulting in at least 25 battle deaths annually, as well as WHO polio surveillance information. Datasets included all countries with populations greater than 100,000, and spans from 2003 — when Nigerian Islamists first advocated a boycott of polio vaccination programs — to 2014. Insurgent groups were defined as Islamist if Islam was used to justify conflict, while those that did not were categorized as non-Islamist insurgents. Negative binomial regression was used to quantify the relationship between insurgency and polio, with other confounding factors such as per capita GDP and population and rural controlled during analysis.
While no positive association between Islamist insurgency and polio throughout the entirety of the study period was noted, countries affected by Islamist insurgency between 2012 and 2014 reported a significantly increased number of polio cases (incidence rate ratio [IRR], 126.7; P < .001). This trend was maintained when controlling for other confounding variables (IRR, 29.7; P < .001). Non-Islamist insurgency was positively associated with polio from 2003-2005, but the relationship lost its significance when controlled. This, along with the discrepancy between the two conflict types during the later time period, suggests that non-Islamist insurgency is not the driving cause of observed increases, the researchers wrote.
The researchers said action against vaccination programs does not have a religious basis, but appears to be influenced by interactions with domestic and international rivals. In particular, they attribute reports of counterinsurgency operations masquerading as immunization programs as the primary impetus for these behaviors among Islamist insurgents.
“The main barriers to polio eradication are no longer medical or technical because of improvements in vaccines and the administration of vaccines,” Kennedy said in the release. “Polio persists and continues to spread because of political and social barriers that stop the effective implementation of polio eradication programs.” – by Dave Muoio
Disclosure: The researchers report no relevant financial disclosures.