This Islamic Leader Is Helping Boost Measles Vaccination Rates in the Philippines

Author: Jacky Habib

UNICEF Philippines/2024/Larry Monserate Piojo

Earlier this year, Khardawi Abdullah received a phone call asking him to support health workers efforts to vaccinate children against measles. The Philippines was battling an outbreak and Abdullah, an imam — a Muslim religious leader — felt obligated to step in. He felt particularly compelled to dispel popular misconceptions about the vaccine being haram — forbidden by Islamic law — and to clarify that it is actually Islamically sanctioned (halal).

Abdullah, who has been a religious scholar for a decade, lives in the Bangsamoro Autonomous Region in Muslim Mindanao (BARMM), a Muslim-led autonomous region in the Philippines. The region has the country’s lowest vaccination rates, which according to UNICEF, is partly due to religious beliefs about vaccines being forbidden. In 2024, the vast majority of measles cases in the Philippines — 77% — came from the BARMM region. 

“We have to accept that for many people in the world, religion is one of the most [influential] factors that can convince people [to change their behavior],” Abullah told Global Citizen.

Across the BARMM region, community members often trust religious leaders more than they trust health workers, which is why religious leaders like Abdullah play a crucial role in educating community members about health issues through the lens of their faith. 

“[People] say the vaccine is not acceptable in the teachings of Islam,” he said. “It is all due to the lack of knowledge — a lack of information about vaccines and the teachings of Islam.”

Abdullah, second from the right, is photographed with other religious leaders in the Bangsamoro Autnomous Region in Muslim Mindanao on April 5, 2024. Across the BARMM region, community members often trust religious leaders more than they trust health work
Image: UNICEF Philippines/2024/Larry Monserate Piojo

The Ministry of Health recorded 668 measles cases in the first quarter of 2024, which it stated was likely much lower than actual figures. Organizations, including the Ministry of Health and UNICEF, relied on religious leaders like Abdullah to help boost vaccination rates. He spent a month traveling across the BARMM region with nurses, community health workers, and other Muslim religious leaders, speaking in mosques and meeting with community members one-on-one to share the health-related teachings of Islam. 

This wasn’t the first time faith leaders in the region participated in health campaigns. In 2018, Muslim religious leaders in BARMM convened to discuss the Islamic stance on vaccinations with the support of the Ministry of Health, UNICEF, and other health organizations. In 2019, they issued a religious ruling (known as a fatwa) stating that vaccines are permitted in Islam. 

“It is the teaching of Islam that you have to prevent yourself from any harm including disease. In Islam, there are two kinds of medications. We have al wikaya — prevention — and il ilaj — medication,” he said. “[With vaccines], you are preventing your body from being hit by diseases so we always say that prevention is better than cure.”  

While there is no specific treatment for a measles infection, individuals can protect themselves against severe complications by nearly 100% when all doses are administered. Measles is a highly contagious and deadly disease which mostly impacts children and spreads through air when an infected person breathes, coughs, or sneezes. Common complications include pneumonia and diarrhea, while severe complications can include respiratory failure, brain swelling (encephalitis), and death.

Children in the Philippines are susceptible to contracting measles due to low vaccination rates, which have led to nearly 900 deaths of children in the last five years. In the BARMM region, only 60% of eligible children received their first dose of the measles vaccine and only 51% received a second dose. This represents a significant discrepancy as 95% of infants must be vaccinated for the country to avoid the threat of measles.

Measles Outbreak and Immunization Response in the Bangsamoro Autnomous Region in Muslim Mindanao.

Measles Outbreak and Immunization Response in the Bangsamoro Autnomous Region in Muslim Mindanao.
Cairon Guro, a midwife of Barangay Dimalna Health Center in Marawi City, Lanao Del Sur, BARMM, gives measles vaccine to children in their village during the measles immunization campaign on April 2, 2024.
UNICEF Philippines/2024/Larry Monserate Piojo

Measles Outbreak and Immunization Response in the Bangsamoro Autnomous Region in Muslim Mindanao.

Measles Outbreak and Immunization Response in the Bangsamoro Autnomous Region in Muslim Mindanao.
Organized by BARMM's Ministry of Health, with support from the national government’s Department of Health, as well as UNICEF Philippines and World Health Organization, an intensive immunization program aims to end the continuing measles outbreak.
UNICEF Philippines/2024/Larry Monserate Piojo

Measles Outbreak and Immunization Response in the Bangsamoro Autnomous Region in Muslim Mindanao.

Measles Outbreak and Immunization Response in the Bangsamoro Autnomous Region in Muslim Mindanao.
According to UNICEF, the BARMM region has recorded 630 measles cases in the first quarter of 2024.
UNICEF Philippines/2024/Larry Monserate Piojo

Measles Outbreak and Immunization Response in the Bangsamoro Autnomous Region in Muslim Mindanao.

Measles Outbreak and Immunization Response in the Bangsamoro Autnomous Region in Muslim Mindanao.
Children in the Philippines are susceptible to contracting measles due to low vaccination rates, which have led to nearly 900 deaths of children in the last five years.
UNICEF Philippines/2024/Larry Monserate Piojo

These targets are the aim of Gavi, a global vaccine alliance which works to boost immunization rates globally to avoid preventable deaths by expanding vaccine access through partners including the UN, donor countries, and philanthropic funders. Globally, Gavi has administered 1.8 billion vaccinations through preventative vaccination campaigns, which have averted 17.3 million deaths. Funding for such programs is crucial for countries like the Philippines and community leaders like Abdullah to continue implementing and supporting such vaccination campaigns. 

As a religious leader, Abdullah said he was often welcomed into people’s homes where he would ask them their views on vaccinations and alleviate their concerns. His fondest memories from his month-long advocacy trip include relieving the worries of parents who were hesitant about the vaccine.

Although one family rejected visits from conventional health workers six times previously, they were open to meeting with Abdullah. He managed to reassure them that the vaccine is safe and halal and informed them of their obligation to protect their health, which led to them vaccinating their children. 

Despite his best efforts, Abdullah said some households “are just listening and it’s in one ear, out the other.” At times, conversations became heated. 

“When the person is … 100% anti-vaccine, they don’t want to vaccinate [their children] and they threaten us,” he said, while adding that health workers often have it worse. As he traveled across the region with them, they shared stories about being chased away from people’s homes. On one occasion, a group of health workers had a gun pulled on them. 

While this work isn’t easy, Abdullah said he believes it is important. 

“It is hard. Really, it is very hard [but when we are successful], I feel happy for them and happy for me too.”

As a religious leader, Abdullah said he was often welcomed into people’s homes where he would ask them their views on vaccinations and alleviate their concerns.
Image: UNICEF Philippines/2024/Larry Monserate Piojo