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Measles vaccination: global progress local challenges
On Nov 10 2016 Progress Toward Regional Measles Elimination–Worldwide 2000–2015 was published jointly by UNICEF WHO Gavi and the US Centers for Disease Control and Prevention. The publication reports on progress made towards achieving UN Millennium Development Goal 4 set in 2000 to reduce child mortality through measures including the elimination of measles in four of six WHO regions.
The two-part MCV1 and MCV2 measles vaccination programme saved an estimated 20 million lives during the 15-year period although there are still 360 child deaths from measles globally every day. Continuing outbreaks are particularly prevalent in countries including Egypt South Sudan and Ethiopia where effective geographical coverage for every child is an issue and surveillance systems are weak. But there have also been outbreaks in the past 2 years in Germany and Mongolia affecting older people small children are not the only vulnerable group. Overall deaths declined by 79% during this period from an annual 651 000 to 134 200 but there remain gaps in the reach of the programme as well as risks caused by the anti-vaccination movement that together leave no room for complacency.
The anti-vaccination movement is particularly active in the USA. Proponents believe that vaccines are as dangerous as the diseases they are designed to protect against. Strangely President-elect Trump seems to support their cause. He should declare vaccine confidence a priority for his government. This year the Pan American Health Organization reported the American region as the first (and only) world region to be measles-free yet 2016 has seen outbreaks in 16 US states most of those people affected were unvaccinated.
In spite of the measles vaccination programme not achieving the four region elimination goal or milestones there has been considerable progress. However as long as there are gaps in coverage complete elimination of measles will remain elusive. Global and regional political and practical support are needed to build upon the impressive progress to date.