WHO warns about potential global Measles rebound

GENEVA: The World Health Organization (WHO) has warned that progress towards the elimination of measles has stalled. 

The number of deaths from measles increased from an estimated 122 000 in 2012 to 145 700 in 2013, according to new data published in the WHO Weekly Epidemiological Report and the Centers for Disease Control and Prevention’s (CDC) Morbidity and Mortality Weekly Report. The estimated number of measles deaths in 2013 represents a 75% decline in mortality since 2000, significantly below the target of a 95% reduction in deaths between 2000 and 2015.

Despite being vaccine-preventable, measles is still an important cause of death and disability among children worldwide. Strong efforts are needed to maintain the current level of control and to continue reducing the number of cases and deaths. WHO and its partners in the Measles & Rubella Initiative have been warning for a number of years that the disease has the potential to rebound if vaccination and surveillance efforts are not maintained and strengthened.

Reduced funding puts impressive gains at risk
Impressive gains have been made towards measles elimination in recent years and an estimated 15.6 million deaths were prevented through vaccination during 2000-2013. The huge reductions in mortality, however, are tapering off.

In developing countries it costs around US $1 to vaccinate a child against the disease, making the measles vaccine one of the best buys in public health. During 2013, 205 million children were immunized against measles through large-scale campaigns in 34 countries, including Cambodia, Cape Verde, Ghana, Jordan, Senegal, and Sudan.

However, while estimated coverage with the first dose of the measles vaccine increased globally to 83% by 2009, it has remained static since, still standing at 83-84% through 2013.
More than 60% of the estimated 21.5 million children who were not vaccinated against measles at 9 months of age last year came from six countries:

• India (6.4 million)
• Nigeria (2.7 million)
• Pakistan (1.7 million)
• Ethiopia (1.1 million)
• Indonesia (0.7 million)
• Democratic Republic of Congo (0.7 million)

Failure to vaccinate children against measles puts them at risk of severe health complications such as pneumonia, diarrhoea, encephalitis, and blindness. The vast majority of deaths from measles occur in developing countries, and in 2013 over 70% of estimated global measles deaths occurred in the six countries listed above.

Getting back on-track

According to the WHO, barriers that are hampering immunization efforts will need to be addressed, including diminishing funding and the need to strengthen health systems. Seven countries are already planning to roll out mass vaccination campaigns in November 2014: Benin, Burkina Faso, Cote d’Ivoire, Lao PDR, Mali, Mauritania and Yemen. The Democratic Republic of the Congo started a one-year rolling campaign in 2013 that finished in August 2014.