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The Case for Measles Elimination: A Joint Effort

Yesha is an ACTION summer intern focusing on child health and vaccinations. She’s a senior at Dartmouth College pursuing a major in government and biology modified with geography.

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Every time I visited the pediatrician as a child, I remember bringing along with me a yellow card that closely resembled a report card. The “report card” was a record of my routine immunizations from infancy to 18 yrs. One of the many strongly suggested routine vaccinations on the “report card” was the Measles, Mumps, Rubella (MMR) vaccine.

In fact, children are not allowed to attend most public schools in the US without proof of this vaccine. The efforts and resources directed towards eliminating measles through vaccination, an engrained aspect of the US healthcare system taken for granted, is a luxury not afforded in many lower income countries. However, recent donations from civil society organizations and donor countries have provided more resources to eliminate measles.

Last week, Lions Clubs International announced it will raise US$30 million for measles vaccinations around the world in alignment with their mission to provide everyone with the ability to see a better tomorrow. Measles blindness is the leading cause of blindness among children in low income countries.  

Lions Clubs donation will be joined by pledges from the UK and the Bill and Melinda Gates Foundation through the GAVI Alliance’s Matching Fund – raising the total contribution to US$60 million. Measles elimination in five out of the six World Health Organization Regions by 2020 is on the horizon with the help of contributions such as these.  

With the prevalence of many life-threatening diseases …why should measles be a priority?

§  Firstly, measles is a highly contagious respiratory disease and a leading killer of children under five, killing around 158,000 children in 2011. Individuals diagnosed with measles are often the world’s most disadvantaged.

§  Secondly, one of twenty children with measles develops pneumonia – another leading killer in children under five worldwide. Eliminating measles has a chain effect, reducing other leading killers in children under five.

§  Thirdly and most importantly, measles is preventable and elimination is possible. The measles vaccine prevents spread of measles and only costs 23 cents.

…But with few measles cases in developed countries, why should donor countries care?

The 15 largest recent outbreaks were in developing countries like the DRC (with 73,934 cases). However, measles outbreaks still occur in developed countries due to measles importation and low vaccine coverage rates. For example, the US reported 222 cases of measles in 2011, the UK reported 2,000 cases in 2012 and France reported 4,937 cases just between January and March of 2011.

Eliminating measles isn’t just the right thing to do, it’s cost-effective too. Measles importation is costly. In the UK and Canada, it was shown that each measles case costs between $US 307 and $US 254 to treat despite a vaccine that costs less than $20.

Lastly, what are we doing, where are we now and what more can we do?

The Measles Rubella Initiative, a partnership between the American Red Cross, CDC, UN Foundation, UNICEF and WHO is currently pooling resources to fight against measles. Since its establishment in 2001, the Initiative and its partners raised measles vaccination coverage to 84% globally and aims to reach coverage of 95% by 2015.

The Lions Club donation, matched by donations from the UK and the Gates Foundation, contributes to these efforts, but is this enough?

Funding gaps in 2008 and 2009 led to outbreaks worldwide and setback progress made towards measles elimination. Countries such as the US, Canada and UK have consistently provided resources to lower income countries to combat measles, but many other donor countries remain absent[1].

 Eliminating measles worldwide requires the effort of everyone, and with only 11% left to reach the goal of 95% coverage by 2015, now would be the time for each country to do their part.

 


[1] Data obtained DFID Project Database and OECD health expenditure data from 2008-2012.