Progress in Reducing Measles, Rubella, and CRS Worldwide

Measles

• Efforts to vaccinate more children against measles led to a 74% reduction in measles deaths worldwide, down from an estimated 535,300 deaths in 2000 to 139,300 in 2010.
• Sub-Saharan African countries made the most progress, reducing measles deaths by about 85% between 2000 and 2010. 
• In 2010, about 85% of the world’s children received one dose of measles vaccine by their first birthday, up from 72% in 2000.
• A global Measles and Rubella Laboratory Network has grown from 80 national and reference laboratories in 2001 to 172 serving 159 countries in 2011.
• In 2010 India accounted for an estimated 47% of worldwide child deaths due to measles. India has since intensified efforts to offer an additional dose of measles vaccine to children living in the most at-risk areas.
• Measles vaccination campaigns often include other lifesaving interventions. The Measles and Rubella Initiative and its partners have supported and  financed the distribution of more than 41 million insecticide-treated bed nets for malaria prevention, 113 million doses of deworming medicine, 137 million doses of polio vaccine, and 245 million doses of vitamin A.
• Measles elimination has been sustained in the Americas since 2002, and important steps are being taken to achieve this goal in three other WHO regions (Europe, Eastern Mediterranean, and Western Pacific) by 2015 or before.  The Western Pacific Region is near to achieving its 2012 elimination goal, with only 5 cases per million population (annualized) reported in the first half of 2012.  In 2009, the African Region adopted the goal of eliminating measles by 2020, and the South-East Asia Region passed a resolution urging countries to mobilize resources to support elimination of measles; although a target date has not yet been set, discussions are continuing.

Publications About Progress in Measles Control

• Assessment of the 2010 global measles mortality reduction goal: results from a model of surveillance data. Lancet 2012; 379:2173-78.
• Global Measles and Rubella Strategic Plan : 2012-2020. WHO 2012
• Progress in Implementing Measles Mortality Reduction Strategies—India, 2010–2011 MMWR 30 Sep 2011;60(38):1315-1319.
• Measles Outbreaks and Progress Toward Measles Preelimination—African Region, 2009–2010 MMWR 1 Apr 2011;60(12):374-378.
• Progress Toward Measles Control—African Region, 2001–2008 MMWR 25 Sep 2009;58(37):1036-1041.
• Progress Toward the 2012 Measles Elimination Goal—Western Pacific Region, 1990–2008 MMWR 26 Jun 2009;58(24):669-673.

Rubella and CRS

• The number of WHO Member States using rubella-containing vaccine (RCV) in their national childhood immunization schedule increased from 83 (43%) in 1996 to 130 (67%) in 2010.
• Over the same time span, the percentage of countries using RCV
• Increased from 60% to 100% in the Americas.
• Increased from 74% to 100% in Europe.
• Increased from 37% to 78% in the Western Pacific Region.
• Increased from 43% to 67% in the Eastern Mediterranean Region.
• Goals to eliminate rubella and CRS have been established in the WHO Region of the Americas (by 2010) and the WHO European Region (by 2015). The WHO Western Pacific Region has established targets for accelerated rubella control and CRS prevention by 2015.
• In 2008, the burden of CRS in developing countries was estimated to be 112,000 cases, down from about 120,000 cases in 1996. (New CRS disease estimates will be available shortly.)
• In 2011, GAVI opened a funding window for rubella vaccine. GAVI will be providing support for the MR vaccine, grants to support vaccine introduction, and part of the operational costs for a catch-up campaign targeting children aged 9 months to 14 years, 11 months. Rubella Vaccines: WHO Position Paper

Additional Resources

• Strebel PM, Gacic-Dobo M, Reef S, Cochi SL. Global use of rubella vaccines, 1980–2009.  J Infect Dis. 2011;204 Suppl 2:S579-84.
• Muscat M, Zimmerman L, Bacci S, Bang H, Glismann S, Mølbak K, Reef S, etal.  Toward rubella elimination in Europe: an epidemiological assessment.  Vaccine. 2012;30(11):1999-2007.
• Goodson JL, Masresha B, Dosseh A, Byabamazima C, Nshimirimana D, Cochi S, Reef S. Rubella epidemiology in Africa in the prevaccine era, 2002–2009. J Infect Dis. 2011;204 Suppl 1:S215-25.
• Castillo-Solórzano C, Marsigli C, Bravo-Alcántara P, Flannery B, Ruiz Matus C, Tambini G, Gross-Galiano S, Andrus JK. Elimination of rubella and congenital rubella syndrome in the Americas. J Infect Dis. 2011;204 Suppl 2:S571-8.