Measles deaths decline, but elimination progress stalls in some regions

Improved vaccination rates critical for success

Note for the media

17 January 2013 | GENEVA – 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 WHO, a leading member of the Measles and Rubella Partnership. Although the WHO Region of the Americas¹ has sustained measles elimination since 2002, and the WHO Western Pacific Region² is on track to achieve elimination, large outbreaks of measles are jeopardizing progress in the remaining regions that have these goals.

Success of vaccination coverage

WHO recommends that every child receive two doses of measles vaccine³. The new data, published in this week’s edition of the Centers for Disease Control and Prevention’s (CDC) 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 Partnership, more than 1 billion children have been reached through mass vaccination campaigns ― about 225 million of them in 2011.

Unprotected population

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)
Pakistan (0.9 million)

Measles outbreaks

In 2011, large measles outbreaks were reported in all these countries and several others in:

DRC (134 042 cases)
Ethiopia (3255 cases)
France (14 949 cases)
India (29 339 cases)
Italy (5189 cases)
Nigeria (18 843 cases)
Pakistan (4386 cases)
Spain (3802 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.

Measles Initiative partnership

Launched in 2001, the Measles Initiative is a partnership — led by the American Red Cross, United Nations Foundation, U.S. Centers for Disease Control and Prevention, UNICEF and WHO — committed to reducing measles deaths worldwide.

In April of 2012, the partners of the Measles Initiative introduced a new global plan to jointly tackle measles and rubella using the same strategy and a combined measles-rubella vaccine. This new strategy is represented in its new name, the Measles & Rubella Partnership. The Initiative’s goal is now to reduce measles deaths worldwide by 95% between by 2015 and to eliminate measles and rubella in at least five of six WHO regions by 2020.

Note to editors

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:

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;
reduce and maintain annual measles incidence to <5 cases per million; and
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 Partnership 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.
Other countries reporting large measles outbreaks in 2011

Afghanistan (3013 cases)
Chad (8650 cases)
Ethiopia (3255 cases)
France (14 949 cases)
Indonesia (21 893 cases)
Italy (5189 cases)
the Philippines (6538 cases)
Romania (4189 cases)
Somalia (17 298 cases)
Spain (3802 cases)
Sudan (5616 cases)
Uganda (3312 cases)
Zambia (13 324 cases)

Measles & Rubella Partnership
The Measles & Rubella Partnership 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 WHO.

For more information please contact:

Tarik Jasarevic
WHO Communications Officer
WHO, Geneva
Mobile: +41 793 676 214
E-mail: jasarevict@who.int

¹ WHO Americas Region countries include: Antigua and Barbuda, Argentina, Bahamas, Barbados, Belize, Bolivia (Plurinational State of), Brazil, Canada, Chile, Colombia, Costa Rica, Cuba, Dominica, Dominican Republic, Ecuador, El Salvador, Grenada, Guatemala, Guyana, Haiti, Honduras, Jamaica, Mexico, Nicaragua, Panama, Paraguay, Peru, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, Suriname, Trinidad and Tobago, United States of America, Uruguay, Venezuela (Bolivarian Republic of).

² WHO Western Pacific Region countries include: Australia, Brunei Darussalam, Cambodia, China, Cook Islands, Fiji, Japan, Kiribati, Lao People’s Democratic Republic, Malaysia, Marshall Islands, Micronesia (Federated States of), Mongolia, Nauru, New Zealand, Niue, Palau, Papua New Guinea, Philippines, Republic of Korea, Samoa, Singapore, Solomon Islands, Tonga, Tuvalu, Vanuatu, Viet Nam.

³ The first dose of measles-containing vaccine (MCV1) is recommended for children aged 9-15 months of age and a second dose of measles vaccine (MCV2) is recommended to be given through routine vaccination programmes to children in the second year of life or at school entry or through mass campaigns to children under 5 years of age. The exact ages will vary by country depending on the measles situation and programmatic issues.