According to a WHO press release on 24 April, the partners have announced a new global strategy aimed at reducing measles deaths
and congenital rubella syndrome to zero.
The announcement comes with the publication of new data using a
state-of-the-art methodology showing that accelerated efforts to reduce measles
deaths have resulted in a 74% reduction in global measles mortality, from an
estimated 535 300 deaths in 2000 to 139 300 in 2010.
Progress in sub-Saharan Africa
Vaccination has been key to this progress. Through increased routine
immunization coverage and large-scale immunization campaigns, sub-Saharan
Africa made the most progress with an 85% drop in measles deaths between 2000
and 2010, according to a new study published in today’s Lancet.
Vaccinating over a billion children
Since 2001, the Measles Initiative has supported developing countries to
vaccinate over one billion children against measles. Now, in keeping with the
new Global Measles and Rubella Strategic Plan to control and eventually
eliminate measles and rubella, the initiative is called the Measles &
Rubella Initiative. Measles and rubella elimination naturally go hand-in-hand,
as measles and rubella vaccines are routinely combined in a single shot.
“A three-quarters drop in measles deaths worldwide shows just how effective
well-run vaccination programmes can be,” says Dr Margaret Chan,
Director-General, World Health Organization . “Now we need to take the next
logical step and vaccinate children against rubella, too.”
Investment and political commitment are critical
The new data underscores that progress in reducing measles deaths was
especially strong from 2001 to 2008. However, when investment and political
commitment to measles control faltered in 2008 and 2009, many children were not
immunized. Measles came roaring back and caused large outbreaks in Africa,
Asia, Eastern Mediterranean and Europe. In 2010, an estimated 19 million
infants – mostly in sub-Saharan Africa and South-East Asia – did not receive
measles vaccine.
These outbreaks combined with a delayed start in intensifying measles
control in India, meant that the goal of 90% reduction in measles mortality by
end 2010 compared with 2000 levels was not met. India accounted for about 47%
of global measles deaths in 2010. In addition, target dates for measles
elimination goals in the WHO Eastern Mediterranean and European regions had to
be revised.
“Recent measles outbreaks have affected children in the world unevenly, with
the poorest and youngest children the most at risk of death or disability,”
said UNICEF Executive Director Anthony Lake. “This new Strategic Plan stresses
that measles and rubella vaccinations must be delivered to children deep in the
poorest and hardest to reach communities.”
Strategic Plan to cut deaths
The new Strategic 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 measles case management;
- communication and community engagement; and
- research and development.
“Measles continues to kill children around the world and rubella is the
leading infectious cause of congenital malformations in newborn infants; these
are avoidable tragedies,” says Thomas R. Frieden, M.D., M.P.H, CDC Director.
“This new plan outlines strategies we know work. It is time to partner with key
countries to implement the plan in order to save our children from these
terrible diseases.”
Under the new strategy, 62 countries currently not using rubella vaccine are
encouraged to use their measles vaccination delivery system to introduce
rubella vaccine into their national immunization schedule and protect families
against both diseases with one combined shot . Many high-income countries
already offer routine immunization for both measles and rubella through the use
of combined measles-rubella or measles-mumps-rubella vaccine.
Millions of volunteers join the combat
"The American Red Cross leverages the capacity of its partners in the
Red Cross and Red Crescent network and their network of millions of volunteers
to combat these two diseases," said David Meltzer, Senior Vice President,
International Services of the American Red Cross. "By working closely with
these volunteers – trusted neighbors and community members – to literally go
door-to-door, explaining the importance of receiving routine immunizations and
participating in campaigns, we can continue to fight these deadly
diseases."
The newly-renamed Measles & Rubella Initiative has strong support from
GAVI and is welcoming new partners including the American Academy of Pediatrics,
International Pediatric Association, Lions Clubs International and Sabin
Vaccine Institute.
Financial support for the vaccine
From 2012, developing countries can apply to GAVI for financial support with
the combined measles-rubella vaccine, a low-cost and effective vaccine,
deliverable through existing immunization structures. GAVI will also continue
to offer the measles second dose vaccine.
“We’re delighted to strengthen our partnership with the renamed Measles
& Rubella Initiative, which has done great work to reduce measles
infections and reduce mortality,” GAVI CEO, Dr Seth Berkley MD, said. “With
GAVI’s US$ 605 million investment for both the combined MR and measles second
dose vaccines in developing countries, this is an historic moment for the reduction
and hopefully eventual elimination of both diseases,” he said.
US$ 112 million still needed
According to Kathy Calvin, CEO of the United Nations Foundation, an
additional US$ 112 million is needed to achieve the global measles and rubella
goals for 2015. “We need significant commitments from governments and the
private sector if we are going to stop measles and rubella, as well as the
support of individuals worldwide because a small donation from the public can
go a long way and help save many lives.”
The release of the new measles mortality data and the Strategic Plan
coincides with WHO’s World Immunization Week, with over 180 countries worldwide
rolling out various activities to raise awareness and take action on the
importance of immunization.
About measles and rubella
Measles is one of the most infectious diseases known to humankind and an
important cause of death and disability among children worldwide. Those
unvaccinated against the disease are at risk of severe health complications
such as pneumonia, diarrhoea, and encephalitis (a dangerous infection of the
brain causing inflammation) and blindness. The disease can be fatal. The vast
majority of measles deaths occur in developing countries.
Rubella, transmitted through airborne droplets, is generally a mild illness.
But when a pregnant woman becomes infected, particularly during the first
trimester of pregnancy, serious consequences can occur including miscarriages,
still births, and infants born with birth defects known as Congenital Rubella Syndrome
(CRS). The most common congenital defects include lifelong heart problems,
deafness or blindness (cataracts). An estimated 112 000 cases of CRS occur each
year and are preventable through vaccination.
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. Since 2001,
the Initiative has supported 80 countries to deliver more than one billion
doses of measles vaccine, helped to raise measles vaccination coverage to 85% globally,
and reduced measles deaths by 74%. These efforts have contributed significantly
to reducing child mortality as per Millennium Development Goal 4.
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