Trust, vaccines, and the state (The Nation (Pakistan))

In the same week that it was announced that the Dutch company Mars One intends to send 24 people to the red planet by 2025, a Saudi cleric offered a breathtaking new insight on the workings of the solar system, fearlessly taking on the scientific community and hundreds of years of irrefutable heliocentric fact. According to the cleric in question, not only does the Sun revolve around the Earth, the Earth itself does not spin, with this theory being ‘proven’ through the imaginative use of a glass of water deployed as a prop to demonstrate planetary motion. When it was pointed out that these beliefs were patently false, the cleric was quick to argue that his findings, backed by religious scripture, could not possibly be wrong, and that any ‘evidence’ used to discredit his ideas would obviously be the products of a Western conspiracy not dissimilar to the one that, according to him, made use of Hollywood to successfully fool the world into believing that the moon landings had actually taken place.
Even as Galileo turns in his grave, it is perhaps not surprising to find these pronouncements coming out of a country whose religious establishment has, in the past, ruled that Mickey Mouse is a ‘soldier of Satan’, and that women working with men who are not related to them can only be permitted to do so if they breastfeed their colleagues. The absurdity of these statements is selfevident, and it would be extremely unfair to assume that they represent the views of Muslims in Saudi Arabia and elsewhere, the vast majority of whom lead thoroughly modern lives underpinned by many of the same assumptions, expectations, and routine considerations that shape the worldviews of people across the globe. To take the inchoate ramblings of a decrepit religious clerisy as being evidence of a malaise unique to the ‘Muslim world’ (itself a questionable construct) is clearly incorrect.
Nonetheless, ridiculous as these ‘scientific’ fatwas might be, it is necessary to consider the roots of these ideas and, more importantly, the political role that they play in society. For one, there is evidence to suggest that religious belief, coupled with a literalist view of scripture, is often associated with skepticism about science and scientists; indeed, this has been found to be true not only for some Muslims, but also for elements of the Christian community, particularly in the United States. Following from this, it could also be argued that illiteracy and a lack of scientific education also have a role to play in rendering people susceptible to erroneous claims about science.
There is, however, more to this story. While Pakistan’s travails with polio are well known, with local clerics invoking religious authority to discredit the vaccination campaign and to justify the targeting of health workers, it is interesting to note that there is a rising tide of antivaccination sentiment in the United States and Western Europe, epitomized in the recent weeks by the resurgence of measles, a disease that had been all but wiped out in those parts of the world.
There are important differences between the antivaccination campaigns in Pakistan and the West. In Pakistan, polio vaccination has long been associated with the machinations of foreign countries conspiring to weaken Pakistan, with fears about the vaccine rendering young boys sterile also tapping into deeper concerns about masculinity and the patriarchal order. These fears, which have been cynically exploited by religious militants and leaders for their own political gain, can be linked to a broader narrative in Pakistan, fostered by the state, that has deliberately cultivated a siege mentality vis-a-vis the rest of the world. The case of Dr. Shakil Afridi, used by the CIA to locate Osama Bin Laden under the pretext of a vaccination drive, only deepened extant suspicions.
In the United States and Europe, antivaccine sentiment cuts across the boundaries of religion, class, and education, and has largely been influenced by the work of doctors like Andrew Wakefield whose claims in the 1990s about the link between vaccines and autism, while thoroughly discredited, continue to exert a tremendous effect on those who are distrustful of a scientific establishment that is all too often seen as being too close to the pharmaceutical industry and the government. Issues of personal and parental autonomy also enter into the debate, with the right to choice being invoked, particularly in the United States, by politicians animated by an agenda geared towards reducing state intervention in society.
What links these different manifestations of vaccine skepticism is paranoia about the intentions of states and their alleged allies in the medical and scientific communities. In an age of neoliberal capitalism, where state power and authority have been systematically eroded in theory and practice, attendant notions of individual choice and autonomy fit well with a broader view of public welfare that sees it being guaranteed through the actions of selfregulating markets and private actors. That this logic can perversely lead to the fragmentation of responses to problems that necessarily require coordinated, collective responses such as climate change or outbreaks of preventable diseases is not unexpected. The problem is compounded when considering how states themselves have done much to justify the suspicions they inspire. As more and more revelations emerge about the scale and extent of illegal surveillance by the United States and other countries, as well as the links between powerful corporate interests and governments, it is only natural that those who have long distrusted the intentions of their leaders will continue to feel vindicated in their stance.
In Pakistan, unsurprisingly enough, the state has historically pursued a paradoxical path, attempting to cement its authority through the use of a national discourse that has ultimately proven to be selfdefeating. Through its attempts to garner legitimacy through religion, and through its constant appeasement of the most reactionary segments of society, the state has cultivated and unleashed the very same millinerian forces that now dominate the public discourse. It is pointless to speak of madrassah reform at a time when graduatelevel textbooks in public sector universities continue to peddle religious dogma in place of scientific fact, and it is not difficult to see why polio vaccination might be taken to be a Western conspiracy when successive governments have repeatedly attributed Pakistan’s problems to hidden ‘foreign’ hands.
Dealing with these problems, in the West and in Pakistan, will require a concerted effort to address concerns about state authority, with meaningful attempts being made to bridge the democratic deficit that has emerged in tandem with the disintegration of state authority in the area of public welfare. That this would require substantive political and economic reform is obvious; after all, distrust of the established order is what continues to fuel the careers and agendas of leaders and corporate interests that use the rhetoric of democracy to mask their private ambitions. Similarly, in Pakistan, education alone is not sufficient; instead, it is also imperative that the poisonous narratives propagated by the state be challenged, and that there be an engagement with the kind of progressive politics that puts the interests and wellbeing of the citizenry above the creation of dubious alliances with shadowy religious organizations and the pursuit of nebulous geostrategic goals in the name of ‘national security’.