Rumors that the polio vaccine causes sterility in children circulate not just in Pakistan but also in many parts of Africa. To outsiders, these rumors might appear to be the result of ignorance or of odd cultural beliefs. But on closer examination, such rumors are found to be a natural and logical consequence of distrust. When international agencies and governments that locals already have reasons to doubt swoop in and focus intensely on one disease, it does not inspire confidence—it does the opposite.
There is a way to both strengthen the fight against polio and begin to build a core of trust between the people at risk and those trying to help. It isn’t simple, nor is it easy to raise funding for the changes that are required: prioritizing basic health care, providing reliable sanitation, and improving infrastructure. But these basic services would build trust, and, along with immunization, they could help break the chain of polio transmission in the disease’s last strongholds.