HEALTH: Global Campaign to Curb Measles Begins in Africa

By Marwaan Macan-Markar Reprint | | Print |

Marwaan Macan-Markar

MEXICO CITY, Mar 30 2001 (IPS) - Eight African countries will serve as the launching pad for a new global effort to reduce the mortality rate of measles, a childhood disease still deemed “deadly” in close to 40 countries across the developing world.

The east African nation of Tanzania, in fact, will be the first to benefit from such an effort spearheaded by two United Nations agencies, the World Health Organisation (WHO) and the UN Children’s Fund (UNICEF).

In August this year, the WHO and UNICEF will provide a first dose of measles vaccines to all infants in Tanzania and thereafter guarantee a “second opportunity” for children, thus ensuring that as many children are immunised.

“We are hoping to achieve a 90 percent coverage rate,” said Dr. Edward Hoekstra, senior health advisor and head of the global measles initiative at UNICEF. “This will require getting all the children from one to five years to be present at hospitals and health clinics in Tanzania to be vaccinated.”

What both the WHO and UNICEF seek through this concerted global effort is to halve by 2005 the number of children dying from measles. “Near blanket coverage is crucial for containing the disease,” declared the WHO and UNICEF in a joint statement on Thursday, when the Global Measles Strategic Plan (GMSP) was launched.

Measles is still “a major childhood killer”. According to the WHO, there have been “over 30 million cases and nearly 900,000 annual deaths in recent years”.

What is more, reveals the Geneva-based health body, measles accounts for the largest number of the estimated 1.6 millions annual deaths due to childhood diseases for which there are preventive vaccines available. The other vaccine-preventable diseases are polio, diphtheria, tuberculosis, pertissis and tetanus.

“These figures are even more shocking given the fact that effective immunisation, which includes vaccine and safe injection equipment, costs just 0.26 US dollars and has been available for more than 30 years,” said Dr. Bjorn Melgaard, director of Vaccines and Biologicals at the WHO.

According to Hoekstra, the measles death toll is due to the insufficient use of the measles vaccines. “In over 20 countries the dosage has not been properly administered to the infants,” he told IPS.

And that is reflected in a WHO study, which revealed that in 1999 measles vaccine coverage was below 50 percent in 14 countries. They included Afghanistan, Burkina Faso, Burundi, Cameroon, Democratic Republic of the Congo, Djibouti, Liberia, Madagascar, Niger, Senegal, Somalia and Togo.

By contrast, countries in the developed world have maintained close to 100 percent measles vaccine coverage, which is often included in the mix of dosages administered to children.

“Even in Latin American this is so due to a successful measles vaccination drive by the Pan American Health Organisation,” affirmed Hoekstra.

In fact, the GMSP is expected to draw from the success achieved in Mexico, where a spray has been used as part of the measles immunisation effort.

But, as Hoekstra observed, the success of the GMSP, which is expected to cost 40 million dollars in the fist year, also depends on a change in political attitudes towards this disease. “Politicians and policy-makers in affected countries in Africa and parts of Asia have not focused on measles recently, assuming it is not a problem.”

In Africa, for instance, he attributes such an attitude to it not being “a high health priority”, unlike the Human Immunodeficiency Virus (HIV), which causes the Acquired Immune Deficiency Syndrome (AIDS). “This has resulted in routine immunisation going down over the last few years.”

And, as Hoekstra added, this viral disease cannot be ignored, given the ease with which it spreads, often by infected droplets during sneezing and coughing, through direct contact with nasal or throat secretions of infected persons or by touching contaminated objects.

According to the WHO, in large populations that are not immunised, measles epidemics occur every two to three years. “Among highly susceptible populations in crowded settings, the opportunity for explosive point source outbreaks is great.”

High-risk groups, in the world body’s estimation, include the urban poor, school children, ethnic minorities “who may have been under- served or may have rejected immunisation for cultural reasons”, hospitalised children and children in refugee camps.

Equally worrying for health experts are the complications that can arise in children infected with measles, like becoming handicapped due to deafness and going blind. “In areas where vitamin A deficiency is a problem, children with measles may be precipitated into acute vitamin A deficiency with resulting impairment or loss of vision from corneal ulceration and dry eye,” states the WHO.

According to the Global Alliance for Vaccines and Immunisation (GAVI), children denied regular measles vaccination are among the 30 million children born every year in poor countries still not being immunised for the six vaccine-preventable diseases.

The GMSP is determined to reverse this pattern, admitted Hoekstra. “We need to vaccinate more children to stop the mortality rate, not to eradicate measles.”