Normally, when we think of the word “shots” in association with the Taliban, the first thing that comes to mind is a group of fighters firing rifles at a group of women attempting to protest the new government. But at least one scientist thinks we’re not expending enough effort to make sure the Taliban focuses on vaccinating everyone in Afghanistan. Not just for COVID, but also polio and other preventable diseases. Doctor Zulfiqar A. Bhutta is the founding director of the Centre of Excellence in Women and Child Health at the Aga Khan University in Karachi, Pakistan. His group also operated a teaching hospital in Kabul and worked for many years under the American-backed Afghani government to vaccinate families and improve nutritional diets across Afghanistan. But now that the Taliban is back in town, those efforts are rapidly falling apart. Writing in the journal Nature, Dr. Bhutta calls on the Taliban leadership to honor their commitments and deliver the health services that Afghan families need and grew to expect under the previous government. Good luck with that, Doc.

Since the Taliban retook Afghanistan last month, I’ve been worrying about the resurgence of polio and other diseases there and beyond.

Children’s and women’s health was already precarious in Afghanistan, despite fragile gains in the past two decades. I fear that it will now get precipitously worse. That would be a local humanitarian disaster with global implications. Both polio and COVID-19 infections in Afghanistan could spread to neighbouring countries. Until transmission is interrupted, the entire world is at risk…

The Taliban now running the country has an opportunity to show a pragmatic, reformist face to the world and people of Afghanistan: it needs to run the health system, to care more about protecting women and children than obsessing about spies and political opponents. It should honour its stated commitment to allow female health-care workers and educators to continue working, for girls to get back to school and for the polio-immunization programme to resume.

The story Dr. Bhutta tells is both inspirational and depressing. Following the fall of the Taliban in 2001, his group began a campaign to vaccinate 17 million children against measles. In two years they managed to achieve 96% of that goal. In a relatively short period of time, measles was nearly wiped out in Afghanistan after having devastated the population for decades. Expanding polio vaccinations was tougher, but by 2014 they reached a 60% level, though rural areas were still lagging significantly.

That all began to change when the Taliban initially started retaking control (albeit unofficially) in a number of rural provinces in 2018 and 2019. They banned healthcare workers from going door-to-door to vaccinate children. Many of the nurses who were women were forbidden from performing the work entirely. Things had already gotten markedly worse by this year, with eight vaccinators and polio workers being killed by “unidentified gunmen” earlier in 2021.

One of Dr. Bhutta’s biggest concerns is the lack of money to fund such programs even if the Taliban were to allow them to resume. He notes that $7 billion in United States funds for Afghanistan are now frozen, along with money from other international health organizations. Whatever money that had previously been in the Afghan government’s coffers has apparently already “disappeared.” So the government has no money to pay NGOs willing to restart the vaccination work for children.

While I admire Dr. Bhutta’s goals and perseverance, he seems a bit overly hopeful when he writes, “I am optimistic that Taliban leaders could be persuaded to permit vaccinations again.” They have already demonstrated that don’t want people going door-to-door doing anything other than enforcing Sharia law. They are suspicious of any activity not directly sanctioned by them. And considering how many people they have already killed, I highly doubt that they are losing much sleep over the country’s vaccination rates.

Judge the Taliban by their actions, not their words. They are precisely who we already knew they were. I would certainly love to see a full-scale children’s vaccination program against measles and polio spring into action. But I remain highly dubious that the Taliban will make anything like that happen.