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Global Problems Can be Solved

Measles Deaths Decline, but Elimination Progress Stalls in Some Regions

Improved vaccination rates critical for success

Geneva/New York/Atlanta/Washington, D.C. —   January 17, 2013

The number of measles deaths globally decreased by 71% between 2000 and 2011, from 542,000 to 158,000. Over the same period, new cases dropped 58% from 853,500 in 2000 to 355,000 in 2011, according to new data released Thursday by the World Health Organization, one of the five lead partners of the Measles and Rubella Initiative. Although the WHO Region of the Americas has sustained measles elimination since 2002, and the WHO Western Pacific Region is on track to achieve elimination, large outbreaks of measles are jeopardizing progress in the remaining regions that have these goals.

WHO recommends that every child receive two doses of measles vaccine.   The new data, published in this week’s edition of the CDC’s Morbidity and Mortality Weekly Report and then in WHO’s Weekly Epidemiological Record, show overall progress in reducing deaths is linked largely to increased vaccination coverage. 

Estimated global coverage with a first dose of vaccine increased from 72% in 2000 to 84% in 2011. The number of countries providing the second dose through routine services increased from 97 in 2000 to 141 in 2011.
Since 2000, with support from the Measles & Rubella Initiative, more than 1 billion children have been reached through mass vaccination campaigns ― about 225 million of them in 2011.

Despite this global progress, some populations remain unprotected. An estimated 20 million children worldwide did not receive the first dose of vaccine in 2011. More than half of these children live in five countries: the Democratic Republic of the Congo (DRC) (0.8 million), Ethiopia (1 million), India (6.7 million), Nigeria (1.7 million), and Pakistan (0.9 million).

In 2011, large measles outbreaks were reported in all these countries and several others: in DRC (134,042 cases), Ethiopia (3,255 cases) India (29,339 cases), Nigeria (18,843 cases), Pakistan (4,386 cases) France (14,949 cases), Italy (5,189 cases), and Spain (3,802 cases). Most of these countries are in WHO regions which have committed to eliminate measles by 2015 or 2020.

The measles outbreaks pose a serious challenge to the regional elimination efforts and signal where national health systems and routine immunization programmes need strengthening. Resuming progress in reducing measles cases and deaths means strengthening health systems so that they can provide effective immunization services and laboratory-supported surveillance for vaccine-preventable diseases to all children.

The outbreaks also indicate the need to ensure that parents are fully aware of the benefits of immunization and the risks associated with not vaccinating children.

World Health Assembly agreed milestones
In 2010, the World Health Assembly established three milestones towards the future eradication of measles to be achieved by 2015:
1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) for children aged 1 year to ≥90% nationally and ≥80% in every district or equivalent administrative unit;
2) reduce and maintain annual measles incidence to 3) reduce estimated measles mortality by >95% from the 2000 estimate.

Global Measles and Rubella Strategic Plan
Since then, WHO and partners in the Measles and Rubella Initiative have developed a Global Measles & Rubella Strategic Plan 2012-2020. The plan presents a five-pronged strategy to cut global measles deaths by at least 95% by 2015 compared with 2000 levels and to achieve measles and rubella elimination in at least five WHO regions by 2020. The strategies include: high vaccination coverage; monitoring spread of disease using laboratory-backed surveillance; outbreak preparedness and response and case management; communication and community engagement; and research and development. See: www.who.int/.../Measles_Rubella_StrategicPlan_2012_2020.pdf

Other countries reporting large measles outbreaks in 2011: Afghanistan (3,013 cases), Chad (8,650 cases), Ethiopia (3,255 cases), France (14,949 cases), Indonesia (21,893 cases), Italy (5,189 cases), the Philippines (6,538 cases), Romania (4,189 cases), Somalia (17,298 cases), Spain (3,802 cases), Sudan (5,616 cases), Uganda (3,312 cases), Zambia (13,324 cases).

Measles & Rubella Initiative
The Measles & Rubella Initiative is a global partnership committed to ensuring no child dies from measles or is born with congenital rubella syndrome. Founded originally as the Measles Initiative in 2001, it’s led by the American Red Cross, the United Nations Foundation, the U.S. Centers for Disease Control and Prevention, UNICEF and the World Health Organization.  See: www.measlesrubellainitiative.org

For more information, contact:
Tarik Jasarevic, WHO, Geneva, +41 793 676 214, jasarevict@who.int
John Brittain, UNICEF, New York, + 212 326 7452, jbrittain@unicef.org
Niki Clark, American Red Cross, Washington, DC, + 1 212 251 8638, Niki.Clark@redcross.org
Eric Porterfield, UN Foundation, Washington, DC, +1 202 352 6087, eporterfield@unfoundation.org
Alan Janssen, CDC, Atlanta, +1 404 639 8517, axj3@cdc.gov

Related link

“Progress in global control and regional elimination of measles, 2000-2011” can be accessed from 12:00 EST at www.cdc.gov/mmwr, and from 18 January on www.who.int/wer/2013/en

 
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