Counterterrorism policies and practices: health and values at stake.

Abstract

The United States Central Intelligence Agency (CIA) used a fake vaccination programme to obtain DNA (deoxyribonucleic acid) samples in the search for Osama Bin Laden, which caused distrust and hampered polio eradication and other public health efforts in Pakistan.1,2 The Obama administration’s vow that the CIA will never again exploit a vaccination programme in its counterterrorism efforts therefore came as welcome news to global health and humanitarian communities.3 Distrust and suspicion that public health programmes are being used to advance foreign interests have contributed to the increase in murders and violent attacks on vaccination workers.2 There have been setbacks to polio eradication efforts and other public health objectives.2 Counterterrorism policies and practices can have unintended health impacts, especially where health programmes are co-opted or undermined, in countries where health systems are strained and population health indicators are poor. The reach of counterterrorism laws is long and they have adversely affected humanitarian health activities in many countries where identified terrorist groups are active and health needs are increased.4 Humanitarian actions can be categorized as providing material support to terrorists. Material support has been interpreted to include the provision of medical care (but not medicines), which can render the very activities that are associated with the core ethical commitments of the medical and nursing professions illegal.