Measles elimination: progress, challenges and implications for rubella control

Tuesday, 5th of November 2013

[source]Expert Review of Vaccines[|source]

In 2012, WHO and partners published the first global combined strategic plan for measles and rubella control and elimination. In this article, the authors review some principles of measles and rubella vaccination and describe progress toward measles control and elimination and current challenges in different WHO regions. The article also discusses the implications of the experience of measles vaccination programmes for rubella control and elimination. The authors conclude by re-asserting that measles and rubella elimination is biologically feasible BUT its attainment will require a dramatic shift in political will and commitment.  Specifically, the article calls for tailor made and country-specific planning to address a) the diversity of obstacles to achieving and sustaining high routine coverage even in high income countries, b) the delays in implementation of campaigns due to political and economic barriers, c) the inability of some countries to reach all children even via campaigns, d) the paucity of reliable data on coverage and e) the political and social turmoil in many countries raise major challenges to achieving the required population immunity. More details are available at: 

http://www.expert-reviews.com/doi/pdf/10.1586/14760584.2013.814847

Abstract

Measles and rubella are major vaccine-preventable causes of child mortality and disability. They have been eliminated from the Americas and some other regions have also come close to elimination. In this paper, we review regional progress toward measles and rubella control/elimination goals, describe the recent epidemiology of these infections and discuss challenges to achieving the goals. Globally, measles vaccination is estimated to prevent nearly 2 million deaths each year. Despite this remarkable progress, large measles outbreaks have occurred in recent years, often involving older persons who were not vaccinated in earlier years. Such an occurrence would be particularly damaging for rubella control programmes as it could lead to peaks in congenital rubella syndrome. Challenges to achieving and sustaining high vaccination coverage include civil conflict, weak health systems, geographic, cultural and economic barriers to reaching certain population groups and inadequate monitoring and use of data for action. Countries and regions aiming to eliminate measles and control rubella urgently need to improve the implementation and monitoring of both routine and mass vaccination campaign strategies.