Measles is on the rise globally, with a 50 percent increase in measles deaths from 2016 to 2019 and the highest number of reported cases in two decades, states a new joint report by the United States Centers for Disease Control and Prevention (CDC) and the World Health Organization, published on Thursday.  

The increase in measles cases coincides with the COVID-19 pandemic, which has disrupted health systems, essential service, and routine immunization programs. Some 94 million people have been at risk of missing vaccines because of paused measles campaigns in 26 countries as of November. 

“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,” said Henrietta Fore, UNICEF Executive Director, in a WHO press release.

Steady progress towards WHO’s goal of global measles elimination was reported from 2000 to 2016, with an 88 percent decrease in incidence of measles. However, the number of reported measles cases then rose by 556 percent within the three subsequent years – from 132,490 cases in 2016, the year with the lowest incidence, to 869,770 cases in 2019. 

In 2019, nine countries – Central African Republic, Democratic Republic of Congo, Georgia, Kazakhstan, Madagascar, North Macedonia, Samoa, Tonga, and Ukraine – experienced large outbreaks. As a result, none of the WHO regions achieved the WHO’s stated objective of eliminating measles by 2020. 

“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,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. 

The report points to the failure to vaccinate children with the two doses of measles-containing vaccines (MCV1 and MCV2), on time, as the primary reason for the increases in cases and deaths. In order to control measles and prevent outbreaks and deaths, vaccination coverage rates have to reach 95 percent. However, currently  vaccination coverage of MCV1 is 84 percent and MCV2 is 71 percent. 

“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,” said Robert Linkins, Measles and Rubella Initiative Management Team Chair and Accelerated Disease Control Branch Chief at the US CDC. 

Experts from the Measles & Rubella Initiative, a global partnership between WHO, US CDC, UNICEF, Gavi Vaccine Alliance, the American Red Cross, and the Bill and Melinda Gates Foundation, called for: the urgent prioritization of measles catch-up immunization programs, actions to regain trust in communities, infection surveillance, rapid outbreak response, and investment in essential health services to mitigate the risk of outbreaks and move towards eliminating measles.

The Immunization Agenda 2030, the global immunization strategy for 2021-2030 that was adopted at the 73rd World Health Assembly, outlines similar strategies to strengthen essential immunization systems and integrate national immunization programs in primary health care systems.

Image Credits: Flickr – UNICEF Ethiopia.