Progress Toward Regional Measles Elimination — Worldwide, 2000–2018

Minal K. Patel, MD; Laure Dumolard, PhD; Yoann Nedelec, MPH; Samir V. Sodha, MD; Claudia Steulet; Marta Gacic-Dobo, MSc; Katrina Kretsinger, MD; Jeffrey McFarland, MD; Paul A. Rota, PhD; James L. Goodson, MPH

Disclosures

Morbidity and Mortality Weekly Report. 2019;68(48):1105-1111. 

In This Article

Abstract and Introduction

Introduction

In 2010, the World Health Assembly (WHA) set the following three milestones for measles control to be achieved by 2015: 1) increase routine coverage with the first dose of measles-containing vaccine (MCV1) among children aged 1 year to ≥90% at the national level and to ≥80% in every district, 2) reduce global annual measles incidence to less than five cases per 1 million population, and 3) reduce global measles mortality by 95% from the 2000 estimate*.[1] In 2012, WHA endorsed the Global Vaccine Action Plan, with the objective of eliminating measles§ in five of the six World Health Organization (WHO) regions by 2020. This report updates a previous report[2] and describes progress toward WHA milestones and regional measles elimination during 2000–2018. During 2000–2018, estimated MCV1 coverage increased globally from 72% to 86%; annual reported measles incidence decreased 66%, from 145 to 49 cases per 1 million population; and annual estimated measles deaths decreased 73%, from 535,600 to 142,300. During 2000–2018, measles vaccination averted an estimated 23.2 million deaths. However, the number of measles cases in 2018 increased 167% globally compared with 2016, and estimated global measles mortality has increased since 2017. To continue progress toward the regional measles elimination targets, resource commitments are needed to strengthen routine immunization systems, close historical immunity gaps, and improve surveillance. To achieve measles elimination, all communities and countries need coordinated efforts aiming to reach ≥95% coverage with 2 doses of measles vaccine.[3]

*The coverage milestone is to be met by every country, whereas the incidence and mortality reduction milestones are to be met globally.
The Global Vaccine Action Plan is the implementation plan of the Decade of Vaccines, a collaboration between WHO; UNICEF; the Bill and Melinda Gates Foundation; the National Institute of Allergy and Infectious Diseases; the African Leaders Malaria Alliance; Gavi, the Vaccine Alliance; and others to extend the full benefit of immunization to all persons by 2020 and beyond. In addition to 2015 targets, it also set a target for measles and rubella elimination in five of the six WHO regions by 2020. https://www.who.int/immunization/global_vaccine_action_plan/en; https://apps.who.int/gb/ebwha/pdf_files/wha65/a65_22-en.pdf.
§Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographic area for ≥12 months, in the presence of a high-quality surveillance system that meets targets of key performance indicators.

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