On polio I absolutely agree that the CIA should not have added fuel to the anti-polio vax fire, but I would point out that the ban against polio vaccination has been there since 2007, well before poor Dr Afridi and his team of health visitors tried to get DNA. The campaign against polio vaccine started even before the 2007 ban on vaccination in Waziristan. You can read more about the Polio Jihad here: http://www.3quarksdaily.com/3quarksd...lio-jihad.html

I am curious, what do you think was the big picture that was missed in Pakistan?

Again, I would add that I dont think the US did a good job. Far from it. I now think the US was not culturally or institutionally capable of obtaining a really good outcome in the region and would have done much better to stay out. Long distance punishment of hostile governments, support to their enemies and carrots to buy them out would have been cheaper and at least as effective, probably far more so. But the US public wanted a war after 9-11 so there was a war. By now the blood lust has settled, so the whole exercise is looking pointless.
But I dont think the mistakes were the ones Kugelman thinks were mistakes. (To be fair, I am not sure what he thinks. I dont think he has spelled out his "lessons learned" in that article).