Vocations and vaccinations: The politics of Oman's anti-measles campaign

A $13 million nation-wide measles vaccination campaign has just wrapped up in the Sultanate of Oman. The campaign, which started in May, offered a free vaccine to between 1.6 and 1.8 million Omani citizens and residents between 20 and 35 years of age.

Oman's Ministry of Health offered measles vaccines at schools, sports clubs and mosques. Mobile teams also distributed the vaccine in less populated areas.

While it appeared to be a standard public health intervention, it may be understood better as an effect of Oman's slow but steady shift toward a more regionalised economic posture. It illustrates the foreign policy challenges Oman faces as it tries to shed its reputation as a "Hermit Kingdom" and become more regionally and globally connected.

It also also highlights the domestic challenge of responding to frustrations over low employment in Oman, particularly among young people. Oman will likely never seek to be an international hub on the level of Dubai - nonetheless, greater regional integration will have domestic consequences, particularly with regards to social welfare provision.

Ultimately, Oman's vaccination campaign is an example of the side-effects of the sultanate's regional policy shifts, and the unintended consequences that may result from them.

The vaccination campaign came in response to an uptick in measles cases in the sultanate over the past two years. In 2016 there were 111 measles cases in Oman and there have been 85 reported so far in 2017. These figures are comparable to the United States - even though the US has a population 73 times that of Oman.

The measles vaccine has been offered in Oman since 1975. Its introduction was highly successful, reducing measles cases in Oman from 679 in 1981 to only 15 in 2001. Measles, however, is a highly contagious virus and outbreaks can occur even among a mostly vaccinated population. Similar outbreaks have led to national measles vaccination campaigns in Saudi Arabia in 2013 and in the United Arab Emirates in November 2015.

Omani health professionals and government officials say that the greater number of foreigners entering Oman from neighbouring countries for tourism, business or work appears to be causing a rise in the numbers of measles cases they are seeing.

The campaign likely began in Dhofar in order to immunise the population ahead of the khareef tourist season when people from across Oman and the Gulf region flock to the regional capital, Salalah

None of the major statements from the Ministry of Health mention South Asian expatriate workers in particular as a culprit of the uptick in measles cases. However, information campaigns about the vaccine in Dhofar province were conducted in Pakistani and Bengali and online campaigns included translations into Indonesian, Hindi and Filipino.

This suggests the government may be reluctant to publicly associate the disease with South Asian expatriates while also seeking to ensure they are vaccinated.

The first phase of Oman's vaccination campaign began in Dhofar Province. While Muscat has seen 18 confirmed measles cases in 2017, Dhofar has seen none - but the campaign likely began here in order to immunise the population ahead of the khareef tourist season when people from across Oman and the Gulf region flock to the regional capital, Salalah.

The campaign also included Wusta despite the province's lack of major population centres, save for the port at Duqm. Because of its small population, officials were able to vaccinate more than half the target population in the province in just two days.

While the first phase of the campaign was scheduled to end on May 20, it was extended until May 27 to increase the number of residents who would be vaccinated. The second phase covered the rest of the country, including the capital and the major port city of Sohar.

While the formal campaign concluded on September 16, the vaccine was made available until September 30. According to the Ministry of Health at least 78 percent of the target population in phase two received a vaccination.

Oman's measles vaccination campaign sits at the intersection of the sultanate's largest foreign and domestic policy initiatives.

On the foreign policy side, regional economic integration has been an important element of Oman's foreign policy. While the sultanate has a policy of neutrality on matters of foreign policy, it enjoys economic cooperation with countries across the Gulf region - including Iran.

Oman's measles vaccination campaign is an example of the higher susceptibility to regional phenomena faced by the sultanate as a consequence of a strategy of greater regional integration

In recent years, Oman has expanded its capacity for regional integration with the opening of the port at Duqm, drawing interest from India and China. It is also expanding the terminal at Muscat International Airport, expanding passenger service at regional airports, and expanding service by regional carriers which intend to turn the sultanate into a second regional hub.

The result has been significantly increased business and tourism traffic between Oman and other Gulf Arab states.

Oman's measles vaccination campaign is an example of the higher susceptibility to regional phenomena faced by the sultanate as a consequence of a strategy of greater regional integration. While such phenomena include economic and political instability in the wake of depressed oil prices, public health concerns - such as measles - also factor into this more regional orientation and require policy interventions.

The secondary effects of strategic policy shifts are often difficult to predict. Nevertheless, it will be important for Oman to anticipate that increased regional ties will change the portfolio of issues it faces.

Domestic factors will also affect the country's future issues. Oman produces significantly less oil per capita than its regional counterparts. Therefore, a diversified economy is more important to Oman than other countries in the region with higher per capita oil rents. Ultimately, Oman seeks to reduce oil revenue from 44 percent of GDP in 2016 to 26 percent by 2020.

In addition, job creation has become more of a priority for Oman's government in the wake of protests in 2011, driven partially by unemployment. The government's National Tourism Strategy, which began in June 2016, seeks to create more than 500,000 jobs by 2040. Increased tourism in Oman, however, will have effects on Omani society including increased exposure to visitors from countries with higher rates of communicable diseases.

As the government looks to provide its citizens with employment and expand its regional integration it will also need to consider these side-effects of its new policies. The measles vaccination campaign is one example of dealing with just one such consequence. The relative success of the campaign suggests that Oman is capable of meeting the challenges that come with greater regional integration, both at home and abroad.

Scott Weiner is an adjunct professor of political science at George Washington University in Washington, DC.