COMPARING MEASLES WITH PREVIOUS ERADICATION PROGRAMS: ENABLING AND CONSTRAINING FACTORS

Monday, 27th of October 2014

[source]Journal of Infectious Diseases[|source]

More than 22 years have passed since the launching of the polio eradication initiative by the World Health Assembly (WHA) in 1988, the last of 5 global eradication activities initiated in the second half of the 20th century. Given that only 1 of these disease eradication programs has been completed successfully (smallpox), serious consideration of a global measles eradication initiative merits a comparison of the enabling and constraining political, social, economic, and technical factors involved in measles eradication with those of the previous and current eradication programs.  

In this report, the authors analyze the merits and demerits of establishing a measles eradication initiative. The report outlines opportunities to build on that facilitate success and threats to mitigate that might threaten success if a global measles eradication initiative is launched at a future date. Detailed analysis and conclusions available at: http://jid.oxfordjournals.org/content/204/suppl_1/S54.long

 

ABSTRACT

BACKGROUND: Five major disease eradication initiatives were initiated during the second half of the 20th century. The enabling and constraining factors—political, social, economic, and other—for these previous and current eradication programs can inform decision making regarding a proposed measles eradication initiative.

METHODS: We reviewed the literature on the yaws, malaria, smallpox, guinea worm, and polio eradication programs and compared enabling and constraining factors for each of these programs with the same factors as they relate to a possible measles eradication initiative.

RESULTS: A potential measles eradication program would enjoy distinct advantages in comparison with earlier eradication programs, including strong political and societal support, economic analyses demonstrating a high level of cost-effectiveness, and a rigorous upfront process, compared with previous eradication initiatives, that has validated the feasibility of achieving measles eradication. However, increasing population density, urbanization, and wars/civil conflicts will pose serious challenges.

CONCLUSIONS: Measles eradication will be very challenging but probably not as difficult to achieve as polio eradication. Measles eradication should be undertaken only if the commitments and resources will be adequate to meet the political, social, economic, and technical challenges.