SVEA CLOSSER then a student at Emory University, Atlanta, Georgia, received funding in May 2006 to aid research on 'Global Development in Policy and Practice: The Polio Eradication Initiative from Atlanta to Rural Pakistan,' supervised by Dr. Peter J. Brown. This case study of a public health project focused on Pakistan, one of the last four countries in the world with endemic polio, and explored the reach, limits, and complex negotiation of the power of UN and bilateral agencies over the Pakistani health system. This research revealed that because the Polio Eradication Initiative is a 'partnership' of donors and UN agencies with country governments, officials at places like the WHO in Geneva have no direct control over the actual implementation of immunization activities. Polio vaccination campaigns are carried out in Pakistan by highly political district health offices along with very poorly paid and largely disgruntled workers. The WHO uses a number of tactics to put pressure on Pakistani government officials, but they are unable to make polio the priority in a nation beset with other, more politically pressing problems. However, due to the donor-directed culture of optimism that pervades upper levels of the project, these issues are never discussed in official publications. These tensions between the culture of global health institutions and local political cultures threaten to undermine the 20-year, six-billion-dollar initiative.
Closser, Svea. 2010. Chasing Polio in Pakistan: Why the World's Largest Public Health Initiative May Fail. Vanderbilt University Press: Nashville, TN.