Africa, Development & Aid, Global, Global Geopolitics, Headlines, Health, Poverty & SDGs

HEALTH: The End of Measles May Be in Sight

Lisa Söderlindh

UNITED NATIONS, Mar 10 2006 (IPS) - Global measles deaths dropped by nearly half between 1999 and 2004, with the greatest reduction in sub-Saharan Africa, according to a new report by the World Health Organisation (WHO) and the U.N. children’s agency UNICEF.

Measles is the leading vaccine-preventable childhood killer in the world, particularly affecting children under the age of five in developing countries with inadequate vaccination services.

While almost totally eliminated in North and South America today, nearly half the deaths caused by the contagious disease occur in Africa. But as a result of major national immunisation drives, worldwide measles deaths fell from 871,000 in 1999 to an estimated 454,000 in 2004, a dramatic plunge of 48 percent.

“This is an outstanding public health success story,” WHO Director-General Dr. Lee Jong-Wook said in a statement Thursday.

Although estimates of global measles mortality for 2005 have not been made available yet, the report says that, “If global progress continues at the rates achieved over the past few years, it appears highly likely that the 2005 measles mortality reduction goal will be met.”

Measles, a contagious respiratory infection caused by a virus, can cause lifelong disabilities, including brain damage and blindness. Although a measles vaccine has been available to protect children since 1960, and costs less than a dollar a dose, the infection accounted for over 40 percent of the 4.1 million annual deaths due to vaccine-preventable diseases in 2002.

Inequalities in access to vaccines within countries means that death and disability from measles is concentrated primarily among the poorest, marginalised and remote people, according to UNICEF.

“Measles remains a major killer of children in the developing world, but it doesn’t have to be,” said UNICEF Executive Director Ann M. Veneman. “Just two doses of an inexpensive, safe and available measles vaccine can prevent most, if not all, measles deaths.”

To reduce measles mortality and widen routine immunisation coverage, the WHO and UNICEF developed the Global Measles Strategic Plan for 2001-2005, which was endorsed by the World Health Assembly in 2003. The plan set out to cut by half the annual number of measles deaths by 2005, compared with 1999 levels.

Components of the comprehensive joint strategy include routine vaccination, mass vaccination campaigns, better surveillance of the disease and treatment of sick children with Vitamin A. The plan targeted the 45 hardest hit countries and mandated that all children should receive a second opportunity for measles immunisation, which increases protection from the disease to about 90 percent.

Looking at the outcome of these efforts, the largest reduction occurred in sub-Saharan Africa, the region with the highest measles burden. Estimated measles cases and deaths fell 59 percent, from 530,000 to 216,000.

Progress in South Asia, where measles was reduced about 23 percent, remained slower because “several large countries had not yet begun large-scale supplementary immunisation activities (SIAs) by the end of 2004”, the report says.

The proportion of countries offering children a second opportunity for measles immunisation also increased, and the number of countries reporting measles cases went up – reaching a total of 174 countries in 2003 compared to 166 in 1999, according to WHO and UNICEF estimates.

However, “investments in strengthening disease surveillance and registration of cause-specific mortality continue to be urgently needed in many developing countries”, the report notes. India, Nigeria, and Pakistan are some of the countries that continue to have a high measles burden.

An important factor behind reducing measles is the support of the Measles Initiative, a partnership initiated by the American Red Cross, the U.S. Centres for Disease Control, UNICEF and the WHO, among others. The initiative has supported vaccination in over 40 African countries, raised funds, and is now expanding its technical and financial support to South Asian countries to strengthen their political and social commitment in the fight against measles.

“Governments’ commitment remains one of the most important factors to eliminate measles,” Erica Kochi with UNICEF told IPS. “Latin America was the first region to eliminate the disease because the governments there were so committed to immunisation.”

Obtaining greater political commitment will also be one of the future challenges as the partnership embarks on the next phase of the mortality reduction efforts. A new, more ambitious goal has been proposed in the Global Immunisation Vision and Strategy (GIVS) document developed by WHO and UNICEF, and which covers 2006-2015.

The new goal is a 90 percent reduction in measles mortality by 2010 compared with the 2000 level. The four strategic areas include; protecting more people in a changing world; introducing new vaccines and technologies; integrating immunisation with other health-linked interventions and surveillance; and immunising in a context of global interdependence.