The Real Story Behind the Conviction of the Pakistani Doctor

by Kevin Jon Heller

I’ve been meaning to blog about the 33-year sentence that Pakistan recently imposed on Shakil Afridi, the doctor who secretly worked with the CIA to locate bin Laden. The United States is predictably up in arms over the sentence, with Leon Panetta recently claiming that “[i]t is so difficult to understand and it’s so disturbing that they would sentence this doctor to 33 years for helping in the search for the most notorious terrorist in our times… This doctor was not working against Pakistan, he was working against al Qaeda.”

Putting aside the ridiculous hypocrisy of the United States criticizing another government for an unfair treason prosecution, Panetta’s statement is profoundly misleading. As the inestimable Glenn Greenwald has explained, Afridi was convicted not because he passed along useful intelligence to the CIA (which is itself debatable), but because he obtained that intelligence by running a CIA-created fake vaccination program for Pakistani children:

What Dr. Afridi actually did was concoct a pretextual vaccination program, whereby Pakistani children would be injected with a single Hepatitis B vaccine, with the hope of gaining access to the Abbottabad house where the CIA believed bin Laden was located. The plan was that, under the ruse of vaccinating the children in that province, he would obtain DNA samples that could confirm the presence in the suspected house of the bin Laden family. But the vaccine program he was administering was fake: as Wired‘s public health reporter Maryn McKenna detailed, “since only one of three doses was delivered, the vaccination was effectively useless.” An on-the-ground Guardian investigation documented that ”while the vaccine doses themselves were genuine, the medical professionals involved were not following procedures. In an area called Nawa Sher, they did not return a month after the first dose to provide the required second batch. Instead, according to local officials and residents, the team moved on.”

That means that numerous Pakistani children who thought they were being vaccinated against Hepatitis B were in fact left exposed to the virus. Worse, international health workers have long faced serious problems in many parts of the world — including remote Muslim areas — in convincing people that the vaccines they want to give to their children are genuine rather than Western plots to harm them. These suspicions have prevented the eradication of polio and the containment of other preventable diseases in many areas, including in parts of Pakistan. This faux CIA vaccination program will, for obvious and entirely foreseeable reasons, significantly exacerbate that problem.

As McKenna wrote this week, this fake CIA vaccination program was “a cynical attempt to hijack the credibility that public health workers have built up over decades with local populations” and thus “endangered the status of the fraught polio-eradication campaign, which over the past decade has been challenged in majority-Muslim areas in Africa and South Asia over beliefs that polio vaccination is actually a covert campaign to harm Muslim children.” She further notes that while this suspicion “seems fantastic” to oh-so-sophisticated Western ears — what kind of primitive people would harbor suspicions about Western vaccine programs? – there are actually “perfectly good reasons to distrust vaccination campaigns” from the West (in 1996, for instance, 11 children died in Nigeria when Pfizer, ostensibly to combat a meningitis outbreak, conducted drug trials — experiments — on Nigerian children that did not comport with binding safety standards in the U.S.).

When this fake CIA vaccination program was revealed last year, Doctors Without Borders harshly denounced the CIA and Dr. Afridi for their “grave manipulation of the medical act” that will cause “vulnerable communities – anywhere – needing access to essential health services [to] understandably question the true motivation of medical workers and humanitarian aid.” The group’s President pointed out the obvious: “The potential consequence is that even basic healthcare, including vaccination, does not reach those who need it most.” That is now clearly happening, as the CIA program “is casting its shadow over campaigns to vaccinate Pakistanis against polio.” Gulrez Khan, a Peshawar-based anti-polio worker, recently said that tribesman in the area now consider public health workers to be CIA agents and are more reluctant than ever to accept vaccines and other treatments for their children.

Glenn also points out that, were the U.S. the victim of such a ruse, a 33-year sentence would seem mercifully short:

In light of all the righteous American outrage over this prison sentence, let’s consider what the U.S. Government would do if the situation were reversed: namely, if an American citizen secretly cooperated with a foreign intelligence service to conduct clandestine operations on U.S. soil, all without the knowledge or consent of the U.S. Government, and let’s further consider what would happen if the American citizen’s role in those operations involved administering a fake vaccine program to unwitting American children. Might any serious punishment ensue? Does anyone view that as anything more than an obvious rhetorical question?

There are numerous examples that make the point. As’ad AbuKhalil poses this one: “Imagine if China were to hire an American physician who would innocently inject unsuspecting Americans with a chemical to obtain information for China. I am sure that his prison term would be even longer.” Or what if an American doctor of Iranian descent had done this on behalf of the Quds Force, in order to find a member of the designated Iranian Terror group MeK who was living in the United States (one who, say, has been working with Israel to help assassinate Iranian nuclear scientists and wound their wives, or one who was trained by the U.S.), after which Iranian agents invaded his American home, pumped bullets in his skull and shot a few others (his wife and a child) and then dumped his corpse into the Atlantic Ocean? Or take the case of Orlando Bosch, the CIA-backed anti-Cuban Terrorist long harbored by the U.S.; suppose a Cuban-American doctor sympathetic to Castro had injected American children as part of a fake vaccination program in order to help Cuba find and kill Bosch on U.S. soil; he’d be lucky to get 33 years in prison.

The predictable U.S. outrage at Afridi’s sentence illustrates the central lesson of the war against terror: no amount of harm to innocent non-Americans is unacceptable, as long as it helps keep Americans safe.

UPDATE: At Lawfare, Ben Wittes claims that nothing he has seen “supports the notion that Dr. Afridi was tried because of his mode of intelligence collection (a fake vaccine program), rather than because—just as Panetta says—he helped the CIA kill Bin Laden.” Unfortunately, Ben has misread my post: I did not claim that Afridi’s involvement with the CIA had nothing to do with his conviction; I claimed (and perhaps I could have been clearer) that the manner in which he assisted the CIA explains why he was selected for prosecution. That claim is obviously based on inference, but my inference is far more persuasive than Ben’s — after all, numerous Pakistani intelligence officials provided intelligence to the CIA regarding bin Laden without facing charges. It does not matter whether the criminal provisions at issue “do not appear to deal with fake vaccinations,” because — again — I did not claim that Afridi’s treasonous act was running the fake-vaccination scheme.

UPDATE 2: Here are the key paragraphs from a recent article in Pakistan’s The International News:

The political administration of Khyber Agency on Wednesday convicted Dr Shakil Afridi, the man who helped the CIA track down Osama bin Laden, and awarded him 33 years in jail on charges of treason, officials said.

Dr Afridi was accused of running a fake vaccination campaign in which he collected DNA samples, which may have helped the American intelligence agency find Osama bin Laden in the garrison city of Abbottabad.

[snip]

On March 29, the Health Department terminated Dr Shakil Afridi from service for organising an unauthorised US-sponsored vaccination campaign in Abbottabad to collect the DNA samples of the people living in the compound where al-Qaeda chief Osama bin Laden lived with his family. The provincial government acted on a summary received in August from the health directorate of Federally Administered Tribal Areas, which was not authorised to initiate an inquiry against an officer above Grade 18.

http://opiniojuris.org/2012/05/27/the-real-story-behind-the-conviction-of-the-pakistani-doctor/

5 Responses

  1. A very important post, Dr. Heller. Thank you. 

  2. Thank you for a valuable broadening of the story. As for the punishment, one might debate the topic as to what we would do. Recall for example days gone by and the US Public Health Service studies of venereal diseases  (at Tuskeegee  and in Guatemala) that harmed many but, to my knowledge, no one went to jail. That was decades ago, but one might argue Pakistan operates some years behind our society.

    I’m not defending the actions – the CIA and the doctor should have made sure that the children received follow up injection – failure to do is just miserable. 

    On Guatemala, see the US Presidential Commission Report at:

    http://bioethics.gov/cms/node/665

    On a doctor involved in both fiascos, see The History of John Charles Cutler at:

    http://www.globaltort.com/2011/08/history-science-and-medicine-the-history-of-john-charles-cutler/ 

  3. An internal independent Pakistani inquiry to investigate the affair suggested trying him on charges of “conspiracy against the state of Pakistan and high treason” for taking part in a foreign intelligence operation.

    In a country where people are often already misguided as to the health benefits of vaccinations, it is certain that Dr. Afridi’s behavior will have a hugely adverse effect and cost on health programs and their recipient children who actually desperately need polio treatment in that country (polio is endemic in Pakistan) - and foreign NGO’s that provide a valuable service against increasing odds e.g. MSF, Save the Children International Committee of the Red Cross have protested this and are already having a tough time because of the incident (also see http://www.mcclatchydc.com/2012/03/02/140671/aid-groups-protest-to-cia-over.html#storylink=cpy). Also, in a state where conspiracy theories became so popular overnight, alleged militants and extremists are now advising people not to accept any vaccinations – and they will probably achieve some success, as usual at the cost of innocent life. Who compensates these civilians?  

    Whilst we cannot know the full true, see this from the NYT about Dr. Afridi’s past:
    “Dr. Afridi had a reputation for hustling as well as healing, and he faced multiple allegations of corruption and professional malpractice, according to officials, colleagues and government papers seen by The New York Times.
    At his private practice, several patients claimed he performed improper operations to make extra money, prompting a local warlord named Mangal Bagh to detain him for a week in 2008 until he paid a fine of $11,100. In June 2010, 11 months before the Bin Laden raid, a female nurse filed a sexual harassment complaint that caused him to lose his job for six months”
      http://www.nytimes.com/2012/05/03/world/asia/bin-laden-raid-fallout-aid-groups-in-pakistan-are-suspect.html?pagewanted=all
     
     

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