An Analysis of the Challenges of Islamic Vaccination Resistance to Disease Eradication Programs and Recommended Mitigations

Abstract

In 1988, the World Health Assembly established the goal of eradicating polio by the year 2000, a goal which, as of 2023, has yet to be attained. Since 2012, polio has been endemic to only three countries—Nigeria, Pakistan, and Afghanistan—all facing widespread vaccination resistance from various organized and unorganized actors, often justified in religious terms. While there has been a considerable amount of recent scholarly research into the relationship between Islamic vaccination resistance and polio eradication, it has yet to produce a theoretical framework for comprehensively explaining the relationship of Islamic vaccination resistance to vaccine-preventable disease eradication generally. This study addresses that knowledge gap by using a multiple case study method to explore Islamic vaccination resistance in Nigeria, Pakistan, and Afghanistan. Leveraging grounded theory, this study investigates the phenomenon of vaccination resistance as it has developed over time, starting from smallpox eradication through the current state of polio eradication and looking ahead to the emerging phenomenon of measles vaccination resistance. Building upon this foundation, this study analyzes the common themes of vaccination resistance, offering a theoretical explanation rooted in the partially overlapping elements of Islamist ideologies and widespread distrust of Western-led, vertical health initiatives. It also uses content analysis to assess the awareness of both the Global Polio Eradication Initiative (GPEI) and the Measles and Rubella Partnership (M&RP) toward critical themes identified in the multiple case study. Finally, this study proposes three principles that the measles eradication program should adopt to proactively mitigate vaccination resistance stemming from ideology and distrust. The first is to bolster accountability through publishing detailed annual status reports and by adopting its own auditing body modeled after the polio program’s Independent Monitoring Board (IMB). The second principle is humility, displayed in forging a program that reflects local health priorities and integrated services rather than one that narrowly targets the goal of eradication. The third and final principle is shared ownership, requiring a measles program that demonstrates ideological neutrality through a genuine, institutional partnership with the Muslim world.

Disciplines

International Relations | Political Science | Social and Behavioral Sciences

First Advisor

Chad Raymond

Date of Award

1-1-2023

Document Type

Dissertation

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