Summary Report on the Consultation with Islamic Scholars on Polio Eradication

This report emerges from an Islamabad, Pakistan, meeting - the first in a planned series of national consultation meetings in the remaining 3 polio-endemic countries, intended to give religious scholars at the national level the opportunity to brainstorm on strategies for a polio-free Islamic world by the end of 2014. The objectives of the consultation meeting were to:

• inform the Muslim scholars about the challenges to polio eradication in Pakistan, particularly with respect to misinformation in the name of religion that has resulted in concerns and fears in certain communities about the polio eradication programme and the oral polio vaccine (OPV);
• seek guidance on strategies that can effectively overcome current social and political challenges to polio eradication in Pakistan;
• seek advice on how best to strengthen the involvement and support of religious scholars and leaders in Pakistan for polio eradication; and
• obtain consensus among the scholars on establishment of a national working committee that will develop ongoing interaction with key religious groups, institutions, and specific audiences in Pakistan on the social and religious aspects of polio eradication.

Attended by international and national Muslim scholars and health experts, the meeting was preceded by a press conference in which the objectives and expected outcomes of the consultation were shared with the media. Following the consultation meeting, a second press conference was conducted to present conclusions, recommendations, and the declaration.

To begin, the participants received an epidemiological update on the global and national situation, which concluded that the polio reservoirs in Central Khyber Pakhtunkhwa (KP), Federal Administered Tribal Areas (FATA), Gaddap Town of Karachi, and the Quetta Block of Balochistan constitute a major risk for the children of Pakistan. In some cases, the situation is aggravated by parental refusals and community reluctance to accept the vaccine, sometimes on religious grounds. Meeting participants noted that due to Pakistan's status as a polio-endemic country from where the virus can spread to other countries, there is now a serious risk of other countries imposing international travel restrictions on Pakistanis. In a separate discussion, meeting participants discussed the efficacy and safety of the OPV. They concluded that Pakistan has the medical and the expertise to ensure that the OPV used in Pakistan is the same as that used in other countries and that it is used in accordance with globally approved standards. Considering health and religious information and arguments, the meeting also concluded that the vaccine vial carries all the required technical information; of particular importance was the consensus that OPV does not contain any haram (sinful) content. It was also concluded that the vaccine does not contain any content that causes infertility, early puberty, or any other health disorder.

Participants subsequently discussed the perception of the polio eradication initiative within communities across Pakistan and addressed issues relating to misconceptions, restriction of access, and parental refusals. Participants found clear indications that false, negative, and misleading material in some scientifically non-reliable publications is aggravating community misconceptions about the polio programme, particularly in polio reservoirs. It was concluded that the Ulama (educated class of Muslim legal scholars) can play a key role in bridging the gap that exists in polio reservoirs between the community and polio eradication initiative.

There was consensus that preventing immunisation is against the teachings of Islam, and the vaccination of children is a religious responsibility. However, the responsibility to ensure the eradication of polio is shared by parents and society, especially religious influencers and community leaders. Meeting participants also discussed recent attacks on polio workers, agreeing that such attacks are against the teachings of Islam and are highly condemnable.

In its concluding phase, the meeting made several recommendations to the polio programme in Pakistan, including the recommendation to form a National Islamic Advisory Group (NIAG) and Reservoir Specific Provincial Scholars' Task Forces (PSTFs). If implemented, these new bodies will take responsibility for developing clear and specific District and Union Council action plans for overcoming misconceptions relating to the religion and improving vaccination teams' access to children. It was further recommended that religious leaders mobilise local A'immah (Imams) to be active at the District and Union Council levels through engagement in District and Union Council Polio Eradication Committees (DPECs and UPECs) in reservoir areas. Polio implementation partners (the World Health Organization (WHO) and the United Nations Children's Fund, or UNICEF) were encouraged to continue their support for the secretariat function for Muslim scholars at the national level, as well as for the PSTFs.

It was further recommended that local Imams address the misconceptions of parents relating to polio vaccination in Friday sermons and that local religious leaders participate in DPECs and UPECs to enable effective planning in the polio reservoirs. Information required to counter religiously-founded misconceptions should be coordinated through the NIAG and PSTFs and widely disseminated to religious leaders through multiple channels, involving religious institutions and relevant media outlets.

As stated here, the media coverage was generally supportive of the meeting taking place and of the Ulema playing a more active and proactive role in polio eradication. The content of the declaration (included within the final portion of the document) was reported extensively. In particular, it was reported that religious scholars and leaders will now be taking a more proactive role in addressing misconceptions about the vaccine and the programme, as well as in raising awareness and disseminating information. The continuing involvement of religious leaders and scholars at District and Union Council levels and through the national Advisory Board for Polio Eradication was highlighted in several reports. Some articles also reported that Islamic scholars had clearly stated that polio vaccine is halal (permissible, per Islamic law), although this was the focus of only a few articles (Urdu language publications).

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