COVID-19 vaccines could go to children first to protect the elderly

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Julian Savulescu, University of Oxford and Margie Danchin, Murdoch Children’s Research Institute

Several COVID-19 vaccines are in late-stage clinical trials. So discussion is turning to who should receive these vaccines first, should they be approved for use. Today, we discuss two options. One is to prioritise the elderly. This article looks at the benefits of vaccinating children first.

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The World Health Organisation is discussing how best to allocate and prioritise COVID-19 vaccines when they arrive.

It is focusing on the immediate crisis. To reduce deaths quickly when there are extremely limited vaccine doses available, vaccinating older, more vulnerable people is expected to be the best option, even if the vaccine is relatively poor at protecting them. That is because the elderly are so much more likely to die from the disease.

But as we produce more vaccines, the goal will be returning to normality where we can freely mix without increased risk. If vaccines are not very effective in older adults, we will need many more people to be vaccinated, including children. One possible strategy is to prioritise children.

Why children first?

The risks and benefits of particular COVID-19 vaccination strategies depend on information we don’t yet have. For example, we don’t yet know whether vaccines work or are safe for specific population groups, such as the young or the old.

But it is worth thinking about the ethics of different strategies in advance. In a pandemic, time can save lives.

A COVID-19 vaccine may be less effective in the elderly because their immune systems decline naturally with age, making them perhaps less able to trigger an efficient, protective immune response after vaccination.

We see this with the flu vaccine, which only reduces influenza-like illnesses by around one-third in the over-65s and deaths by around half.

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Read more:
Why are older people more at risk of coronavirus?

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If there are similar results for a COVID-19 vaccine, to return to normality, we may need to also prevent community transmission through vaccinating young people, who generally mount a stronger immune response. This would in turn protect older, more vulnerable people because the virus would be less likely to reach them.

Yes, this is controversial. Children cannot autonomously consent to being vaccinated. Adults, who make these decisions on their behalf, are also likely to benefit from a reduced risk of contracting the virus within their own household, making the decision a possible conflict of interest.

When would this be OK?

We do sometimes make altruistic decisions on behalf of children. Children can be life-saving bone marrow donors for siblings, for example, despite the risks.

We can also apply the idea that we can restrict liberty where there is a risk of harm to others. For instance, if a child is infected with COVID-19, they need to be isolated and quarantined just like adults.

However, vaccination differs from both examples in one key respect. With vaccination, there is unlikely to be a single identified person the child will help, or whom they are uniquely placed to help. Instead, the potential benefits are collective, to the wider public.

If a child lived with a sibling who had an underlying condition that makes them particularly vulnerable to COVID-19, or lived with their grandparents, vaccination might be an easier choice.

If a child lived with grandparents, vaccination might be an easier choice.
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Three factors could help us decide

When weighing up whether children should be vaccinated ahead of adults, we can ask:

1. How severe is the threat to public health?

So far, more than a million people have died from COVID-19. There’s also the risk of overwhelming health systems and the additional collateral damage in terms of economic, social, educational and risk of excess non-COVID-19 deaths as a result (for example through suicide, or delayed access to health care). COVID-19 affects everyone in society, including children.

2. Are there alternatives?

If vaccination works well enough in vulnerable people, or there are other strategies to achieve the same effect, such as general adult vaccination, we should use those instead.

3. Is the response proportional to the threat?

As we vaccinate the vulnerable, and the general adult population, even if it is not fully effective, we will reduce the severity of the crisis. We should assess at that stage whether the remaining problem warrants vaccinating children.

Assuming we meet these conditions, we argue prioritising childrens’ vaccination, on a voluntary basis at least, is the right strategy.

How about mandatory vaccinations?

Mandatory vaccination can be justified if voluntary strategies do not achieve herd immunity, or do not achieve it fast enough to protect the vulnerable.

To gauge whether mandatory vaccination is worth it, we might also need to consider how lethal and infectious a virus is.

For instance, smallpox had a death rate of up to 30% (although contagion requires fairly prolonged contact). It was eradicated by 1979 through vaccination, which was mandatory in many countries. With COVID-19, 0.1-0.35% of infections are fatal.

By definition, mandatory vaccination involves some form of coercion. This can include withholding financial benefits or access to early childhood education (No Jab, No Pay or No Jab, No Play in Australia); preventing children from entering school (USA, with specific rules varying by state) to fines (Italy). France even has legal provision for imprisonment for parents who refuse certain vaccines.

Mandatory vaccination (of some kind) could be justified in groups who are at increased personal risk from COVID-19 — such as health-care workers, the elderly, men, or people with other health conditions — if incentives such as increased freedoms, or even payment are not sufficient. For these groups, the vaccine is win-win: it both protects others and the person vaccinated.

And mandatory vaccinations for children?

The situation is more tricky with children. Unless they have underlying health conditions or have a rare but serious inflammatory condition after infection, children are less likely to have severe COVID-19 or die from it.

So the risk of the vaccine itself (as yet unknown) weighs more heavily.

On the other hand, children benefit from grandparent relationships, and other freedoms afforded by a pandemic-free society.

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Read more:
Children may need to be vaccinated against COVID-19 too. Here’s what we need to consider

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Mandatory vaccination might be justified in children if the following criteria are met:

• the vaccine is proven to be very safe for children (including in the long term, as yet unknown), and safer than the effects of the disease

• children are significant spreaders of infection (which does not appear to be the case for COVID-19, at least for pre-teens)

• there are other non-COVID benefits to children, such as return to normal social and educational life (school), and access to normal health-care services which they otherwise could not have

• measures are reasonable and proportionate, for instance, by limiting child care benefits (rather, for instance, than sending parents to prison).

We are certainly not close to meeting these criteria for mandatory vaccination of children against COVID-19 yet, especially as we don’t know how effective and safe candidate vaccines are in different populations.

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Read more:
5 ways our immune responses to COVID vaccines are unique

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Julian Savulescu, Visiting Professor in Biomedical Ethics, Murdoch Children’s Research Institute; Distinguished Visiting Professor in Law, University of Melbourne; Uehiro Chair in Practical Ethics, University of Oxford and Margie Danchin, Associate Professor, University of Melbourne, Murdoch Children’s Research Institute

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Why we should prioritise older people when we get a COVID vaccine

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Kylie Quinn, RMIT University

Several COVID-19 vaccines are in late-stage clinical trials. So discussion is turning to who should receive these vaccines first, should they be approved for use. Today, we discuss two options. One is to prioritise children. This article looks at the benefits of vaccinating older people first.

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While we wait for further results from phase 3 trials, it’s clear that supply of any potential COVID vaccine would initially be limited.

Local authorities will need to prioritise distribution to specific groups, at least at first. So how might they make these decisions?

The general consensus is people with very high risk of exposure to COVID, such as workers in front line health-care and quarantine facilities, should be first.

Less clear is the question of who should be next. This group could include people with work, demographic or health characteristics that put them at high risk of either exposure or serious disease.

Following a National Cabinet meeting on Friday, the federal government indicated the elderly and vulnerable would be a priority group.

Here’s why prioritising older people to receive the earliest COVID vaccines is a good idea.

First, a bit of background

Vaccines work in several different ways, providing benefits to the individual and the community.

An obvious individual benefit is that vaccines can prevent infection in the person who is vaccinated. But vaccines can also reduce the amount of virus a person makes if they do end up becoming infected. This can reduce severe disease and reduce their likelihood of transmitting the virus to others.

All this leads to benefits for the community. If vaccine uptake is high enough and transmission is reduced, our collective (or herd) immunity can be used like a fire break. It blocks pathways of virus transmission and protects vulnerable people from infection, even when those people are not vaccinated.

Here’s what happens when you don’t vaccinate compared to when you do, if we were to have a vaccine that was 66% effective. The figures who turn red catch COVID-19.
Author provided

Severe disease due to COVID is a critical health issue, with the potential to put significant stress on health-care systems and resources. But if vaccine supply is limited, do we:

• directly reduce severe disease by giving the vaccine to those most at risk, such as older people

• indirectly reduce severe disease by vaccinating the people most likely to get sick and transmit the virus, such as certain groups of younger people

• use a mix of both strategies?

The question is, how can a limited supply of vaccine have the most impact?

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Read more:
90% efficacy for Pfizer’s COVID-19 mRNA vaccine is striking. But we need to wait for the full data

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Vaccines and the elderly

As we get older, our immune cells can become more difficult to activate, in response to the natural ageing process or other factors like chronic inflammation. As a result, vaccines often don’t protect older people as well as younger people.

Importantly, a phase 1 study with a BioNTech/Pfizer COVID vaccine candidate showed the size of the immune response was lower in older people, which may suggest reduced protection.

Because of this, the public might think prioritising vaccines for older people is a bad idea. Why give a vaccine to people who it won’t work as well in? But we should explore older people as a priority group for several reasons.

First, older people are bearing the brunt of severe disease from COVID. In Australia, nearly half of severe cases requiring intensive care, and more than 90% of deaths, have been people over 65.

Second, a potential vaccine may not protect as well in older people, but it should protect to a degree. As an example, the flu vaccine provides 60-70% protection in the general community, dropping to 30-40% protection in people over 65 — but even at that rate it’s still protecting a substantial number of older people.

Third, where a potential vaccine doesn’t prevent infection, it could still reduce severe disease. For example, in one study, the flu vaccine reduced the rate of severe disease in vaccinated people by 23% regardless of age group.

A modest improvement in cases or severe disease in older people could have a big impact on the overall burden of disease and death.

In particular, aged-care facilities should be considered a top priority. This environment is high risk, combining people at very high risk of severe disease and high-density accommodation. Vaccinating aged-care staff could prevent the virus getting in and vaccinating residents could minimise the consequences if it did.

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Read more:
5 ways our immune responses to COVID vaccines are unique

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Finally, some vaccines may work well in older people. For example, the Shingrix vaccine stunned the research community in 2015 by demonstrating over 90% protection against shingles in older people — a vast improvement on the previous Zostavax vaccine which provided only 50% protection.

While initial supply will be limited, we may end up with access to multiple COVID vaccines, which could allow us to prioritise potent vaccines for older people.

Big decisions take a village

In any scenario, tackling complex questions around vaccine distribution will require specialist knowledge from across many disciplines.

We need to understand how the virus spreads in a given population, how the vaccine works in different groups within that population, who might be hesitant about the vaccine, how we can deliver the vaccine to a wide variety of people and many other factors.

Older people are more likely to become severely unwell if they contract coronavirus.
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Importantly, we’re still learning about this virus. It behaves differently in different communities, due to different environments, demographics, biology and behaviours. Strategies may differ in different regions and must adapt with our evolving understanding of the virus. There won’t be a “one size fits all” approach.

It’s also vital to keep in mind that a vaccine won’t be a silver bullet. Vaccines are not 100% protective and will take time to roll out. Public health measures such as rigorous testing, hand-washing, mask-wearing and a level of social distancing will remain important for some time.

There will be challenging and contentious decisions for initial access to COVID vaccines, but ultimately vaccine supply will become less restricted. It’s important to remember we all collectively benefit by shepherding certain groups to the front of the vaccine queue.

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Read more:
Creating a COVID-19 vaccine is only the first step. It’ll take years to manufacture and distribute

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Kylie Quinn, Vice-Chancellor’s Research Fellow, School of Health and Biomedical Sciences, RMIT University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

A closer look at business cases raises questions about ‘priority’ national infrastructure projects

Glen Searle, University of Sydney and Crystal Legacy, University of Melbourne

Infrastructure Australia’s latest infrastructure priority list has been criticised for being “too Sydney-centric” and for giving Melbourne’s East West Link, cancelled in 2014, “high priority” status. The cancelled Roe 8 project in Perth was removed from the list.

So how does a project get onto Infrastructure Australia’s list? This requires submission of a full business case, which then needs to be “positively assessed” to be given priority status.

But our research, yet to be published, has found these business cases leave out highly significant costs. This article looks at three prominent projects – the WestConnex and East West Link motorways in Sydney and Melbourne respectively, and Cross River Rail in Brisbane – to illustrate how business cases submitted to Infrastructure Australia do not follow its requirements in key respects. This casts serious doubt on the business cases used to justify major motorway projects, as well as on how priority projects are selected.

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Read more: FOI reform needed in Victoria amid East West Link fallout

Read more: Roe 8 fails the tests of responsible 21st-century infrastructure planning

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What do business cases assess?

Ensuring business cases are completed before investment decisions are finalised is critical to “good planning”. Part of Infrastructure Australia’s remit is to head off concerns that projects are committed to before business cases are fully evaluated. This can help minimise “optimism bias” and ensure investments deliver community benefit.

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Read more:
WestConnex audit offers another $17b lesson in how not to fund infrastructure

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But we must also examine what the business case is actually showing us. The main part of each business case is the cost-benefit analysis. This compares the money value of project benefits and project costs. Economically viable projects should have a benefit-to-cost ratio above 1:1.

Infrastructure Australia requires project business cases to consider non-monetised benefits and costs, including community impacts. These benefits and costs are required to be quantified in some other way, or at least described. The basis used to estimate “external costs” must also be provided.

The cost-benefit methodology requires any significant positive or negative impacts on third parties – externalities – to be included. Examples include air quality, carbon emissions, noise, biodiversity and climate adaptation.

Social impacts to be covered include equity or the distribution of benefits (which Infrastructure Australia says need to be identified since cost-benefit analysis does not explicitly take these into account), and affected local communities and other individuals/groups. The non-monetised benefit and cost categories listed as relevant are: social impacts, cultural impacts, visual amenity/landscape, biodiversity and heritage impacts.

In support of monetary estimates, proponents must “describe and provide supporting material that demonstrates how land use, population and employment projections are modelled”.

The guidelines stress that the supporting conditions for expected land use impacts will be in place – for instance, necessary infrastructure investment where densification is assumed. Factors that can hinder the realisation of such benefits (such as local opposition to increasing density) must also be included.

This process would seem to produce a rational prioritisation of national infrastructure projects. The problem is that the business cases submitted to Infrastructure Australia do not follow its requirements.

High-priority projects with problematic business cases

To illustrate this, we analysed the business cases of three projects designated as “high priority” for Commonwealth funding:

• East West Link, to which the Commonwealth allocated A$1.5 billion before the new Victorian government cancelled the project

• WestConnex, which has been allocated A$3.5 billion

• Cross River Rail, which is yet to receive funding.

A key problem in these business cases is that significant project cost items have not been monetised. These include costs relating to environmental effects such as noise and visual amenity and to other impacts on businesses, households and property values.

For example, none of the three cases includes a valuation of the costs of lost business and disruption to household travel and amenity during construction. (This is a big issue with Sydney’s southeast light rail project.)

There is also no costing of the loss of property values along motorways, especially around exhaust emission vents. The East West Link and Cross River Rail business cases make some allowance for this by including the value of general changes in amenity from noise, urban landscape and visual amenity. None of these are costed in the WestConnex case.

Another significant omission relates to the costing of land use impacts. The WestConnex and East West Link business cases both forecast more, and longer, road trips across the network as a result of the projects.

The WestConnex scheme will increase vehicle kilometres by 600,000 per day and make outer suburbs more accessible relative to the inner city. The potential extra costs from greater sprawl are high, estimated at A$4.99 billion for Sydney over 25 years from 2011 if greenfield housing was 50% of new dwellings rather than 30%.

The opposite is the case for Cross River Rail. Increased higher-density development around rail stations would produce infrastructure savings, but the business case does not give these a value.

Furthermore, the valuation of changes in transport mode resulting from each project is inconsistent.

The Cross River Rail business case includes savings resulting from motorists switching from road to rail after the line is built.

The WestConnex project will have the reverse effect, with 45,000 public transport trips per day being switched to the motorway. But the business case does not put a value on the costs of this. These include bus and train revenue losses, or reduced service frequency and increased waiting time to reduce losses.

Debatable ‘wider economic benefits’

The most contentious business case component is wider economic benefits. These are productivity improvements arising from increased central city job density as a result of the projects improving access.

These benefits needed to be included to lift the East West Link benefit-cost ratio above one. But this is only achieved through sleight of hand – public transport improvements into central Melbourne are included as part of the full project cost. As the public transport component of the business case had low costs compared to its benefits, including these wider economic benefits was enough to push the overall ratio above 1.

Similar benefits are part of the WestConnex cost-benefit analysis. However, these benefits are to be achieved from extra car trips to the centre. This takes no account of the disincentives of road congestion and lack of parking.

Current central Sydney planning controls allow a maximum of one new parking space per 75 square metres of floor area for not-so-tall offices – or one space for about five new workers – and even fewer spaces relative to floor area for higher buildings. This means most increased job density will not come from people driving to work.

By contrast, the wider economic benefits of the Cross River Rail resulting from increased job density in central Brisbane are not valued for inclusion in the cost-benefit analysis.

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Read more:
Brisbane’s Cross River Rail will feed the centre at the expense of people in the suburbs

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Rethinking the business case

Our work points to several real concerns:

• a lack of consistency in what is included in business cases
• questions about how cases can be reasonably compared across projects
• discretionary inclusion or exclusion of critical items that bias results in favour of projects.

We need more holistic and integrated analysis of projects. This will take into account not only the “nation-building” aspects – the jobs and growth projects might inspire – but also the disrupting and displacing effects they produce across transport modes, land uses and people’s experiences of the city.

Glen Searle, Honorary Associate Professor in Planning, University of Queensland and, University of Sydney and Crystal Legacy, Senior Lecturer in Urban Planning, University of Melbourne

This article was originally published on The Conversation. Read the original article.

Plinky Prompt: If You Were President of the U.S., what would be your #1 Priority? Why?

Sabari grasses

If I was president of the United States my number 1 priority would probably be having a serious rethink on both Iraq and Afghanistan. It is not that I think the war on terror should be ended – far from it – just that a review of current
policies is probably needed. There are probably some other ways of doing things that are more helpful, useful and directed towards a determination.

Christian Girls Kidnapped in Yemen Are Rescued

Parents, other abducted Christians remain missing.

ISTANBUL, May 18 (CDN) — Saudi Arabian and Yemeni security forces rescued two German girls yesterday, 11 months after the two young sisters, their parents, brother and four other Christians were taken hostage in Yemen.

Reported to be between 3 and 6 years old, the two girls, Lydia Hentschel and her younger sister Anna Hentschel, were part of a group of nine Christian foreigners who were kidnapped on June 12 last year. Three of the adult hostages, a Korean and two German women, were murdered shortly afterwards.

The foreigners worked in a hospital near the city of Saada. No group has claimed responsibility for the kidnapping. Although the German family, a British man, and the three murdered women were Christians, it was not clear if they were kidnapped because of their faith.

There was no indication as to the whereabouts of the girls’ parents, Johannes and Sabine Hentschel, the girls’ 2-year-old brother Simon, and the Briton, identified only as Anthony.

The two girls were found in a disputed border region between Yemen and Saudi Arabia during Saudi cross-border raids in the northern region of Saada, according to Reuters. Saudi and Yemeni security forces collaborated in the operation to free the sisters.

Over the last year violent clashes have flared between Yemeni government forces and the Houthi armed group in Saada. The fighting has reportedly hindered efforts to locate the missing foreigners.

Reuters quoted the German foreign minister as saying the two young sisters were in “relatively good health” and would be transported from Saudi Arabia to Germany on Wednesday (May 19). Foreign Minister Guido Westerwelle said he remained concerned about the safety of the rest of the German family.

Westerwelle told Reuters that learning the whereabouts of the remaining hostages remains a high priority, with efforts “continuing undiminished” and hopes still alive.

Today CNN reported that a spokesman for the German family said it was likely that the youngest sibling, Simon, was dead, since he was not found along with the two sisters.

In the last 15 years nearly 200 foreign nationals have been kidnapped in Yemen, and most have been released unharmed, Reuters reported.

Report from Compass Direct News 

Egyptian Christian women forced to marry, convert to Islam

Coptic Christian women in Egypt are being forced to marry and convert to Islam and that oppression is part of a larger pattern of persecution against Christians facilitated by the Egyptian government, according to two recent reports, writes Baptist Press.

"Cases of abduction, forced conversion and marriage are usually accompanied by acts of violence which include rape, beatings, deprivation of food and other forms of physical and mental abuse," said a new assessment by Christian Solidarity International and the Coptic Foundation for Human Rights.

At the same time, the 2009 U.S. State Department report on international religious freedom noted the Egyptian government fails to prosecute crimes against Copts and even has taken a hand in destroying church property and, in one case, a government official reportedly raped a woman who had converted from Islam to Christianity.

About 90 percent of the Egyptian population is Sunni Muslim, and the rest primarily identify themselves as Coptic Christians, according to the Human Rights Watch report "Prohibited Identities: State Interference with Religious Freedom." Copts typically are underprivileged and experience discrimination.

Egyptian sex traffickers entice Coptic Christian women from low-income families by promising an escape from poverty, then force the women into Muslim "marriages" or outright slavery, according to the CSI/CFHR report.

"Such abuse remains covered in a cloak of silence and tacit acceptance, even though it is against the constitutional affirmations of civil rights," the report said.

Once a Coptic girl is coerced into marriage and Islamic conversion, her family will not take her back, and if she leaves her "husband," she is considered a "disgrace" to her family, the report said. In addition, the Coptic Orthodox Church excommunicates female members who wed Muslim men, the State Department said.

Since Islam is the "religion of state" in Egypt, conversion to Islam is easy, while returning to Christianity is unacceptable, the HRW report said. The Civil Status Department, which issues national identity cards, sometimes refuses to give Coptic women a new card identifying her as Christian since it is considered apostasy for a Coptic woman to leave Islam, even to return to her religion of origin.

Egyptian law requires every citizen to have an identity card for purposes such as voting, employment and education.

Most of the cases of Coptic women being coerced into marriage are not reported and "observers, including human rights groups, find it extremely difficult to determine whether compulsion was used, as most cases involve a female Copt who converts to Islam when she marries a Muslim male," the State Department report said.

In two examples of coerced conversion, CSI/CFHR reported Nov. 10:

— An Egyptian woman was raped and beaten since she would not have sex with the man she was forced to marry. The Coptic cross on her wrist was later removed with acid.

— Another woman was forced to marry a Muslim lawyer and work for him in "slave-like conditions" for five years.

John Eibner, CSI’s chief executive officer, urged President Obama in a letter to combat the trafficking of Christian women and girls in Egypt and to make sure the U.S. makes this issue a priority in its relations with Egypt.

"Trafficking of Christian women in Egypt is not a new phenomenon…. But this problem has now reached boiling point within Egypt’s Coptic community, which views it as symptomatic of a much broader pattern of religious persecution," Eibner said in his letter.

Report from the Christian Telegraph 

More Pakistanis flee new offensive against Taliban

About 40,000 more Pakistanis are leaving their homes in South Waziristan as Pakistan’s military prepares to launch a new offensive against the Taliban, Reuters reports. They join over 2 million other people who have fled the violence since May, reports MNN.

The Christian Reformed World Relief Committee is providing $500,000 of food aid for the refugees through the Canadian Foodgrains Bank. It will deliver 708 metric tons of lentils, oil, fortified wheat flour, sugar, iodized salt, and chili powder to internally displaced person (IDP) camps in the Swabi district of North West Frontier Province, Pakistan.

Two thousand families, or about 14,000 people, live in the camps. CRWRC will give first priority to widows with children and to families who have lost loved ones.

CRWRC received a testimonial from Muhammad Akber Khan.

“I am a senior citizen and the oldest person in my family,” he said. “The continuous shelling compelled us to leave our native town and home. We left everything back home as we were given only 20-25 minutes to leave the town. All that we could have carried were the clothes that we were wearing at the time of migration. We want to go back to our homes as soon as possible as our lifetime investment is there; moreover, we have to supervise our crops that were the only sources of our livelihood. I am grateful to the staff of I-LAP and CRWRC who shared their love and care through giving.”

CRWRC has already distributed mosquito nets, sleeping mats, and water containers in the camps. Its International Disaster Response team responds to natural and man-made disasters all over the world, bringing relief and aid to those who need it most. It works in cooperation with local and international nongovernmental organizations (NGOs) in order to respond quickly and effectively to the urgent needs of a community.

Report from the Christian Telegraph

PAKISTAN: TORTURED CHRISTIAN LANGUISHING ON FALSE CHARGES

Police maneuver to keep incapacitated son of preacher in jail – and out of hospital.

LAHORE, Pakistan, June 23 (Compass Direct News) – A 37-year-old Christian is languishing in a Sialkot jail after police broke his backbone because his father was preaching Christ, according to a local advocacy group.

Arshad Masih had been in a hospital – chained to his bed on false robbery charges – after police torture that began Dec. 28, 2008 left him incapacitated. He was discharged from General Hospital in Lahore on Saturday (June 20) and returned to jail despite efforts by the Community Development Initiative (CDI), a support group that is providing Masih legal assistance.

CDI Research Officer Napoleon Qayyum said that hospital personnel treated Masih callously, but that conditions there were better than in the jail in Sialkot. At least in the hospital, Qayyum said, Masih’s gray-haired father was able to carry him on his shoulders when he needed to go to the bathroom.

Hospital staff members released Masih even though they knew he would not receive the medical care he needs in jail and could face further abuse, the CDI researcher said.

“We told the hospital administration and doctors that Masih would be released from jail within a few days, so he should not be discharged from the hospital as he would not be taken care of in jail, but they paid no heed to our request,” Qayyum said.

He said Sialkot police gave assurances that Masih would be released from jail if he arrived there from the hospital by 10 p.m. A police van left early Saturday morning from Sialkot to bring Masih from the hospital in Lahore to Sialkot jail, but it did not reach the hospital until 6 p.m. even though it is only 100 kilometers (62 miles) from Sialkot to Lahore.

Qayyum said officers also invented delays on the return trip.

“Despite our requests to the police van staff, they reached the jail at 10:30 p.m.,” Qayyum said. “The Sialkot police used the delays to demoralize us by creating problems so that we do not file a petition for torturing.”

The CDI official said the group’s first priority is to “take him out of Sialkot so that police may not further create problems for him.”

Murder Threat

Hajipura police detained Masih on Dec. 28 on orders from the Sadar police station in Gujranwala, where Masih’s father, Iqbal Masih, had been preaching Christ.

The elder Masih, an itinerant preacher who has traveled to remote areas to proclaim Christ for three decades, told Compass that objections to his ministry led to false accusations of robbery against his son. Area Muslims resented his preaching and his visits to a Christian family in Gujranwala, he said, and told him to stop visiting the family.

“They told me that I was preaching a false religion and should stop doing it, and that I should succumb to their pressure,” the elder Masih told Compass.

Area Muslims had complained to Gujranwala police of the elder Masih’s efforts, and officers there first sought to arrest him in a case filed against “unidentified people,” he said. Later, he said, Gujranwala police told Hajipura police to charge his son in some robbery cases, as Arshad Masih lived in the Hajipura precincts.

When police arrested Arshad Masih on Dec. 28, they tortured him for several days, the younger Masih said.

“They hung me upside down all night, beat me and used all inhumane torture methods, leaving me permanently paralyzed,” he said.

Police falsely named him in a robbery case, according to CDI. All others named in the case were released after paying bribes, advocacy group officials said. Police officers also asked Masih’s father for a bribe of 50,000 rupees [US$620], the elder Masih said.

“They asked me as well for 50,000 rupees, but I refused to pay on the grounds that it was illegal and additionally I hadn’t that much money,” Iqbal Masih said.

The complainant in the robbery case eventually testified that Arshad Masih hadn’t been among the robbers, and he was granted bail. Before court orders reached the jail, however, Sialkot police informed Sadar police officers in Gujranwala, who arrived at the jail and had Masih remanded to them for a robbery case filed against “unidentified people.”

“Because of that, Masih could not be freed for one moment,” CDI’s Qayyum said.

Gujranwala police also threatened to kill Masih in a staged police encounter if he told the court that he had been tortured, according to CDI. They also warned him that he should not act as if he were in any pain in court.

The court, however, found him unable to stand and sent him to Allama Iqbal Memorial Hospital in Sialkot for medical examination. Gujaranwala police therefore had to leave him. But police did not tell Masih or CDI staff which police station was keeping Masih in its custody at the hospital.

With the help of the American Center for Law and Justice, CDI filed a case in the Gujranwala Sessions court for Masih’s bail and also provided some assistance for his medical treatment.

On June 16, the Sadar police station investigating officer told the court that police under his command were not detaining Masih, but that the Sialkot police were. Because the Gujranwala police were not detaining him, he argued, bail orders issued on March 23 for Masih’s release pertained to Sialkot and therefore Masih’s police custody in the hospital was illegal.

“The police have been keeping us in the dark so that we could never pursue the case in the right direction,” said CDI’s Qayyum. “How can a brutally tortured patient even heal their wounds in such mental agony when his hand is always tied in chains, and two policemen are maintaining a 24-hour watch over him?”

The researcher said he maintained hope that the judicial system would provide Masih relief from his agony, which has taken its toll on his family as well. Masih has three children that he has pulled from school due to lack of money.

His wife is illiterate and cannot make a living, CDI officials said, adding that Masih’s four married sisters are the main sources of his financial support.

Report from Compass Direct News

IRAN: THREE CONVERTS ORDERED TO STOP ‘CHRISTIAN ACTIVITIES’

Judge puts them on probation, threatening them with ‘apostasy’ trial.

LOS ANGELES, March 31 (Compass Direct News) – Declaring three Iranian Christians guilty of cooperating with “anti-government movements,” a court in Shiraz on March 10 ordered the converts to discontinue Christian activities and stop propagating their faith.

An Islamic Revolutionary Court judge handed an eight-month suspended prison sentence with a five-year probation to Seyed Allaedin Hussein, Homayoon Shokouhi, and Seyed Amir Hussein Bob-Annari. The judge said he would enforce their prison sentence and try them as “apostates,” or those who leave Islam, if they violate terms of their probation – including a ban on contacting one another.

A new penal code under consideration by the Iranian Parliament includes a bill that would require the death penalty for apostasy.

“The warning that they will be ‘arrested and tried as apostates’ if they continue their Christian activities is quite chilling,” said a regional analyst who requested anonymity.

The Islamic Revolutionary Court was created after Iran’s 1979 revolution to prosecute those suspected of seeking to depose the Islamic regime. The “anti-government movements” referred to by the judge are satellite television stations Love Television and Salvation TV. Unlike the Internet, which is heavily censored in Iran, the two 24-hour satellite TV stations can bypass government information barriers.

Sources said links between the accused and these organizations, however, remain tenuous.

“The TV link came up almost six months after [the original arrests], so it is very new,” said an informed source. “We believe they just made it up, or it is something they want to make appear more important than is the reality.”

The three men were arrested by security forces on May 11, 2008 at the Shiraz airport while en route to a Christian marriage seminar in Dubai. According to a report by Farsi Christian News Network (FCNN), at that time the families of the three men avoided formal charges by agreeing to terms of release, including payment of a bond amount. Details of the terms were undisclosed.

 

Churches Pressured

The sentencing of three converts from Islam follows more than 50 documented arrests of Christians in 2008 alone, and the recent government crackdown includes Christian institutions that minister beyond Iran’s tiny indigenous Christian community.

On March 19, Assyrian Member of Parliament Yonathan Betkolia announced that by order of the Islamic Revolutionary Court, an Assyrian Pentecostal church in Tehran would be closed. According to FCNN, the church in the Shahrara area of Tehran was facing closure because it offered a Farsi-language service attended by converts from Islam.

During a speech following his election to Parliament in October, Betkolia had lauded freedoms accorded to minority groups in Iran, and he has publicly protested the Shahrara church allowing “non-Assyrians” – that is, Muslims – to attend services. The regional analyst said that Betkolia made these pronouncements as the increase in government pressure on the Christian community has put him in a difficult position.

“As a representative of the Assyrian community, a priority for Betkolia is to ensure the preservation of the limited freedoms and relative peace his traditional Christian community enjoys,” said the analyst. “Disassociation from a church which has welcomed believers from a Muslim background should therefore be seen as a form of self-defense.”

The number of Assyrian Christians in the country is estimated at between 10,000 and 20,000, with estimates of Armenian Christians in Iran ranging from 110,000 to 300,000.

Advocacy organization Human Rights Activists in Iran strongly criticized the decision to close the Assyrian church.

“The closing of the church is clearly a violation of human rights,” the organization stated, “because the right to change one’s religion and the right of self-expression are hereby targeted by the Islamic Revolutionary Court.”

The pastor of the Shahrara church has indicated that cancelling Farsi-language services may allow it to continue, though it was unclear at press time whether the congregation’s leadership was willing to make that compromise. FCNN reported in February that church leaders had on some occasions cancelled Farsi-language services at church.  

Report from Compass Direct News

EVANGELICALS IN SPAIN SUPPORT SOCIALIST PLAN TO DISSOLVE CATHOLICISM

The executive secretary of the Federation of the Evangelical Entities of Spain, Mariano Blazquez Burgo, has asked the Socialist government to pass a law on the “neutrality” and “laicity” of the State, in order to establish a common equality among all the churches that exist in the country, reports Catholic News Agency.

“We are asking for two laws: one on religious entities and the other on neutrality, laicity, a word which does not frighten me,” Blazquez told reporters during the celebration of the 130th anniversary of the evangelical church of the city of Gijon.

According to the daily “La Nueva España,” evangelicals want the State “to be neutral with regards to all religious beliefs, by advancing laicity, and also with a statute of equality shared by all the churches established in Spain.”

“Not privileges for the churches, but a common statute for all religious entities that is clear and just in rights and obligations,” Blazquez stated, adding that during the Spanish Civil War, evangelicals showed “sympathy for the Republic, saying they were spiritual liberating our nation.”

Since taking power, the government of President Jose Luis Rodriguez Zapatero has made it a priority to remove any religious expression from public life and to impose its own moral formation on students through the Education for Citizens course, which thousands of parents have rejected because of its secular and ideological nature.

Report from the Christian Telegraph