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Global measles deaths drop by 78%, but resurgence likely

450 deaths a day is still too many - stalled momentum puts millions more children at risk

Joint News Release American Red Cross/CDC/UN Foundation/UNICEF/WHO

The Measles Initiative announced today that measles deaths worldwide fell by 78% between 2000 and 2008, from an estimated 733 000 in 2000 to 164 000 in 2008. However, global immunization experts warn of a resurgence in measles deaths if vaccination efforts are not sustained.

All regions, with the exception of one, have achieved the United Nations goal of reducing measles mortality by 90% from 2000 to 2010, two years ahead of target. Vaccinating nearly 700 million children against measles, through large-scale immunization campaigns and increased routine immunization coverage, has prevented an estimated 4.3 million measles deaths in less than a decade.

"So much has been achieved in the past several years thanks to the hard work and commitment of national governments and donors. But with only two years until the target date, there are signs of stalling momentum," said Dr Margaret Chan, WHO Director-General. "This is a highly contagious disease that can quickly take advantage of any lapse in effort."

"We are poised to vaccinate more children than ever in 2010," said Kathy Calvin, Chief Executive Officer for the United Nations Foundation. "Next year, some of the most populous countries: China, Indonesia, Pakistan, Bangladesh, Vietnam, Nigeria, and Ethiopia are planning national immunization campaigns. We're looking at a pivotal year for measles vaccination and the financial commitments haven't kept up with the demand."

The Measles Initiative is tackling a funding gap of US$59 million for 2010; if unaddressed, this resource gap could allow for a resurgence of measles deaths. Immunization experts fear the combined effect of decreased political and financial commitment could result in an estimated 1.7 million measles-related deaths between 2010-13, with more than half a million deaths in 2013 alone, compared to 164 000 in 2008.

Measles is among the world’s most contagious diseases and one of the leading causes of death among children worldwide. Even healthy and well-nourished children, if unvaccinated, are at risk of the disease and its severe health complications such as pneumonia, diarrhoea, and encephalitis (a dangerous infection of the brain causing inflammation). But in vulnerable populations the disease becomes deadly, which is why the vast majority of measles deaths occur in developing countries.

"Despite impressive progress globally, more than 400 children die every day from this completely preventable infection," said Dr Thomas R. Frieden, Director, U.S. Centers for Disease Control and Prevention. "Measles can make a rapid comeback if we don't continue to make progress. We saw this happen in the United States between 1989 and 1991, when an estimated 55 000 measles cases and more than 130 deaths occurred."

The one region that may jeopardize achieving the 2010 goal is South-East Asia—which includes heavily populated countries such as India, Indonesia and Bangladesh—where measles deaths declined only 46% between 2000 and 2008. Delayed implementation of large-scale vaccination campaigns in India, the country with the majority of measles deaths, is largely accountable for this lack of progress.

"Three out of four children who died from measles in 2008 were in India,” said Ann M. Veneman, UNICEF Executive Director. “India’s plan to scale up its measles vaccination campaign in many parts of the country is very encouraging.”

To eliminate the risk of resurgence, countries must continue follow-up vaccination campaigns every two to four years until their healthcare systems can provide two doses of measles vaccination to all children and provide treatment for the disease. Reaching the 2010 goal will also require strengthening disease surveillance systems to rapidly detect and control outbreaks.

"Measles is incredibly resilient and our success is fragile," said Bonnie McElveen-Hunter, Chairman of the American Red Cross. "If we drop our guard, this disease will regain a foothold and spread like wildfire once again. We must stay vigilant."

The new data are published in the December 4 edition of the World Health Organization’s (WHO’s) Weekly Epidemiological Record and the Centers for Disease Control and Prevention’s (CDC’s) Morbidity and Mortality Weekly Report.

The Measles Initiative

The Measles Initiative is a partnership committed to reducing measles deaths globally. Launched in 2001, the Initiative—led by the American Red Cross, the United Nations Foundation, the U.S. Centers for Disease Control and Prevention, UNICEF and the World Health Organization—provides technical and financial support to governments and communities on vaccination campaigns and disease surveillance worldwide.

The Measles Initiative works with several key partners including Becton, Dickinson and Company, Bill & Melinda Gates Foundation, Canadian International Development Agency (CIDA), Church of Jesus Christ of Latter-day Saints, GAVI Alliance, Herman and Katherine Peters Foundation, International Federation of Red Cross and Red Crescent Societies, Izumi Foundation, Japanese Agency for Development Cooperation, Merck Co. Foundation, Monte dei Paschi Foundation, Vodafone Foundation, and countries and governments affected by measles.

For more information please contact:

Hayatee Hasan
WHO, Geneva
Telephone: +41 22 791 2103
Email: hasanh@who.int

Christian Moen
UNICEF, New York
Telephone: +1 212 326 7516
Email: cmoen@unicef.org

Steven Stewart
US Centers for Disease Control and Prevention, Atlanta
Telephone: +1 404 639 8327
Email: znc4@cdc.gov

Amy DiElsi
UN Foundation, Washington, DC
Telephone: +1 202 419 3230
Email: adielsi@unfoundation.org

Abi Weaver
American Red Cross, Washington, DC
Telephone: +1 202 303 6820
Email: weaverAb@usa.redcross.org

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