Canada's goal to eradicate polio in Afghanistan proved to be mission impossible

From The Toronto Star:

OTTAWA, Canada -– Officials trying to eradicate polio in Afghanistan began downgrading the markers of success last year as it became clear Canada had taken on a mission impossible, documents obtained by the Toronto Star reveal.

Eliminating the crippling childhood disease from the insurgency-ravaged country by 2009, primarily with money from the United Nations and World Health Organization, was one of three key projects the government launched last year as it prepared to wind down the military mission and leave a humanitarian legacy in Afghanistan.

But with 20 new polio cases reported so far this year, rising violence and less than four months left in 2009, it is no longer possible to achieve that goal.

"Even if Afghanistan interrupted transmission of the virus now we wouldn't be able to say whether or not it's polio free for another 12 months," said Oliver Rosenbauer, a spokesperson for the WHO's Polio Eradication Group in Geneva.

The Conservative government went public with the process of redefining progress yesterday in a quarterly report to Parliament on the Afghan mission. The document subtly shifts goals laid out more than a year ago, adds statistics about the delivery of food aid and shows the Afghan army is outperforming targets that didn't exist until the report was tabled.

But none of the new indicators hide the fact that the country is sliding deeper into a morass of violence and insurgency. For the period from April to June, there was a 108 per cent increase in the number of incidents involving roadside bombs from the same period in 2008. The military uses that figure as an indicator of Taliban activity.

"The security situation is not good in Afghanistan," said International Trade Minister Stockwell Day, chair of a cabinet committee that manages the mission. "I think it shows the commitment, the devotion, the courage not just of our own troops, but of the people of Afghanistan that in spite of the rise in security problems we continue to see progress – progress that can be measured."

The signature projects the government took on in June 2008 include eradicating polio, refurbishing a dam to irrigate southern Afghanistan and building 50 schools in Kandahar province.

So far, 28 schools are under construction and five more have been completed, but violence in Kandahar has forced 180 of its 364 schools to close. The $50 million Dahla dam project is still in the preparatory phase. A road and bridge necessary for the work to start are nearing completion, but only 199 of an estimated 10,000 jobs the work will create have come to fruition.

But it is too late to achieve Canada's ambition of eliminating polio this year. While cultural resistance, community engagement or the quality of the polio vaccine have hampered eradication efforts in other countries, Afghanistan's only barrier is declining security, mainly in the southern provinces of Helmand and Uruzgan, as well as Kandahar, where Canadian troops and government officials are based.

"It's just trying to figure out a way in those districts where there's conflict how to get the vaccine into the mouths of children without the vaccinators getting killed or shot at," said the WHO's Rosenbauer.

Officials with the Canadian International Development Agency realized how difficult it would be to complete the job last year as they watched the number of new polio cases jump from 10 in July to 16 in September to 25 in November.

A summer spike in violence also led to the death of two Afghan doctors working on polio eradication at the hands of a suicide bomber and threatened the cancellation of plans to vaccinate hundreds of thousands of young Afghans.

All this led to a consideration in August 2008 to subtly change the benchmarks the government set to measure success in the fight against polio, according to email correspondence obtained by the Star. The suggestion was to change the goal of outright polio eradication in 2009 to "no transmission of polio."

The lower standard could speed up achievement of the government's goal by a year, but it was rejected by a senior CIDA official.

"We can't change the ... benchmarks. They are already public."

But the international aid agency did lower the threshold for success on the number of Afghan children affected by Canada's efforts. Instead of measuring the number of children "immunized" against polio, the target was changed to the number of children "vaccinated." A child must be vaccinated several times before they can be considered immune from the virus.