“The tragic murders of nine anti-polio workers in Pakistan last month, followed by the New Year’s Day killing of seven more local community development workers, was both a wake-up call to the global polio eradication effort in its current form, and a ‘canary in the mine’ regarding the deteriorating state of development and security in the country,” Heidi Larson, a senior lecturer and principal investigator at the London School of Hygiene & Tropical Medicine, writes in a SciDev.Net opinion piece. “The past month of public reporting and private discussions on what happened, why and what happens next have revealed a complex web of governance failings, inadequate development structures and a landscape of multiple security threats, both locally and internationally,” she states, describing possible factors and challenges that led to the killings.

“[E]fforts at [polio] eradication should not be pushed as the priority above all others in Pakistan,” Larson writes, adding, “Instead, efforts to eradicate polio need to engage with activities addressing other local priorities — not by temporarily adding other services to polio campaigns, but instead by supporting measures that contribute to long-term, sustainable development.” She continues, “Polio eradication is indeed a priority for global health and, for Pakistan’s leaders, failing to eliminate it would certainly compromise the country’s already fragile regional and global positioning.” Larson concludes, “The last leg of eradication cannot be business as usual. Each step will need to carefully consider the local political, cultural and operational dynamics — and not the dynamics of the past year, but of the current week, and even each new day they operate in” (1/25).