Muslim clerics get a bad rap in an interconnected world. It was once possible to be anti-women, anti-medicine and anti-science without much notice - just control the media - but today that is a difficult task.

In some parts of the world, imams, Islamic school teachers and traditional rulers are making a positive difference and pushing back the vestiges of conspiracy theories about medicine. In defiance of past teaching, they are working with doctors, journalists and polio survivors to turn the tide against polio vaccine rejection in northern Nigeria. 

Sani-Gwarzo Nasir from the Federal Ministry of Health in Nigeria and colleagues describe how anti-polio propaganda, misconceptions, and violence against vaccinators present huge challenges to polio eradication in Nigeria but perhaps most profound is the rejection of vaccination by Muslim clerics.

Pattern of occurrence of cases of wild poliovirus and circulating vaccine-derived poliovirus in Nigeria from 2009 to 2013. This figure summarizes the number of incident (A) WPV and (B) cVDPV cases in Nigeria during the period from 2009 to 2013. The color scheme represents the increasing intensity of incidence from white (zero) to light yellow, to gold, to orange, to red, and to dark red. Credit: 

However, according to the authors, the intense opposition to polio vaccination is systematically being reversed by the active engagement of imams to promote uptake of polio vaccination in areas worst hit by the disease. The authors describe the initiative in which selected imams have attended training sessions and the subsequent widespread community participation may have reduced the number of cases of polio in some regions of northern Nigeria.

The authors say: "This campaign demonstrates that traditional leaders in Nigeria could be relied upon to mobilize religious clerics, who in turn educated and mobilized the community. 

 "Expanding the focus of the existing coalition campaign, which encourages parents to accept the vaccine initiative and have their children immunized, to creating awareness in the community to demand polio vaccination will have a tremendous impact on the polio eradication initiative in Nigeria.

"The sustainability of such efforts remains the greatest challenge to eradication of polio from Nigeria."

Citation: Nasir S-G, Aliyu G, Ya'u I, Gadanya M, Mohammad M, et al. (2014) From Intense Rejection to Advocacy: How Muslim Clerics Were Engaged in a Polio Eradication Initiative in Northern Nigeria. PLoS Med 11(8): e1001687. doi:10.1371/journal.pmed.1001687