Measles surged worldwide in 2019 reaching highest number of reported cases in 23 years. Highlighted in a publication by WHO and the US CDC, measles cases worldwide increased to 869,770 in 2019, the highest number reported since 1996 with increases in all WHO regions. Global measles deaths climbed nearly 50% since 2016, claiming an estimated 207,500 lives in 2019 alone.
After steady global progress from 2010 to 2016, the number of reported measles cases climbed progressively to 2019. Comparing 2019 data with the historic low in reported measles cases in 2016, authors cite a failure to vaccinate children on time with two doses of measles-containing vaccines (MCV1 and MCV2) as the main driver of these increases in cases and deaths.
“We know how to prevent measles outbreaks and deaths,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “These data send a clear message that we are failing to protect children from measles in every region of the world. We must collectively work to support countries and engage communities to reach everyone, everywhere with measles vaccine and stop this deadly virus.”
Measles outbreaks occur when people who are not protected from the virus are infected and spread the disease to unvaccinated or under-vaccinated populations. To control measles and prevent outbreaks and deaths, vaccination coverage rates with the required MCV1 and MCV2 must reach 95 percent and be maintained at national and subnational levels. MCV1 coverage has been stagnant globally for more than a decade at between 84 and 85 percent. MCV2 coverage has been steadily increasing but is only now at 71 percent. Vaccination coverage against measles remains well below the 95 percent or higher needed with both doses to control measles and prevent outbreaks and deaths.
Global Response to COVID-19 Pandemic Must not Exacerbate the Measles Crisis
Although reported cases of measles are lower in 2020, necessary efforts to control COVID-19 have resulted in disruptions in vaccination and crippled efforts to prevent and minimize measles outbreaks. As of November, more than 94 million people were at risk of missing vaccines due to paused measles campaigns in 26 countries. Many of these countries are experiencing ongoing outbreaks. Of countries with postponed planned 2020 campaigns, only eight (Brazil, Central African Republic, Democratic Republic of Congo, Ethiopia, Nepal, Nigeria, Philippines and Somalia) resumed their campaigns after initial delays.
“Before there was a coronavirus crisis, the world was grappling with a measles crisis, and it has not gone away,” said Henrietta Fore, UNICEF Executive Director. “While health systems are strained by the COVID-19 pandemic, we must not allow our fight against one deadly disease to come at the expense of our fight against another. This means ensuring we have the resources to continue immunization campaigns for all vaccine-preventable diseases, even as we address the growing COVID-19 pandemic.”
Causes of Failure to Control Measles Are Many and Must Be Addressed
Global immunization partners are engaging leaders and public health professionals in affected and at-risk countries to ensure that measles vaccines are available and safely delivered, and that caregivers understand the life-saving benefit of the vaccine. On 6 November 2020, WHO and UNICEF issued an emergency call to action for measles and polio outbreak prevention and response.
“Measles virus easily finds unprotected children, adolescents and adults because it is so contagious,” said Dr. Robert Linkins, Measles & Rubella Initiative Management Team Chair and Accelerated Disease Control Branch Chief at US CDC. “Infections are not only a sign of poor measles vaccination coverage, but also a known marker, or ‘tracer,’ that vital health services may not be reaching populations most at-risk. Our collective efforts to reach children with vaccines now, ahead of the possible easing of COVID-19 travel restrictions and increased population movement, will save lives.”
The Measles & Rubella Initiative (M&RI), which includes American Red Cross, the United Nations Foundation, the US CDC, UNICEF and WHO, and global immunization partners like Gavi, the Vaccine Alliance, the Bill and Melinda Gates Foundation and others, are working to address the current measles crisis and ensure that resources are positioned to address immunization delays – for measles and all vaccines — in every region of the world. A bold strategy released by M&RI, Measles & Rubella Strategic Framework 2021 – 2030, will help to address reversals in global progress toward measles elimination by bolstering strong, national immunization systems that can reach and protect children. This strategic shift by the partnership will focus on strengthening the routine delivery of all vaccines, and quickly and effectively detecting and responding to measles outbreaks.