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HEALTH: Hundreds of Thousands Don’t Make It Past Measles

Gustavo Capdevila

GENEVA, May 23 2003 (IPS) - Measles is often seen as a relatively harmless disease, but there are more than 14 million cases reported each year, which claim the lives of at least 700,000 children, 400,000 of them in Sub-Saharan Africa.

"This mortality rate is unacceptable as it is fully preventable" with inexpensive vaccines, says Daniel Tarantola, director of vaccines and biologicals for the World Health Organisation (WHO).

The experts of the WHO secretariat are hoping that the annual meeting of the organisation’s maximum body, the World Health Assembly, gathered in this Swiss city until May 28, will approve a resolution committing the 192 member nations to comply with objectives for fighting measles-related deaths.

An inexpensive and effective vaccine has been available since 1963 and has wiped out measles in the Americas, where there has not been a native case since last November – a considerable achievement given the highly contagious nature of the disease.

The situation is quite different for the rest of the world, and particularly where there are great social disparities. "Measles feeds on social and economic inequality. It appears when countries are poor, have under-equipped health systems and vaccination coverage is low," explained Tarantola.

But it would be "naïve" to say that only developing countries are vulnerable to measles, he said.

According to WHO figures, in 2000 there were 6,000 measles cases reported in Germany and 10,000 in France. Since the beginning of this year, 150 cases have been reported in two Swiss cantons alone.

"That means transmission continues to occur," and those European countries are active reservoirs for exporting measles, warned the WHO official.

Measles is highly contagious, caused by a virus that is spread primarily through droplets of saliva or through direct contact with nasal or throat secretions of an infected person. It can infect children as well as vulnerable adults.

The measles symptoms initially are similar to those of the common cold – tiredness, runny nose, cough – but are accompanied by a high fever and followed by a rash that appears and begins to spread some 14 days after exposure.

"Available measles vaccines are safe, highly effective and inexpensive," costing just 25 cents on the dollar, including the injection materials, says Brad Hersh, member of the WHO anti- measles programme.

The WHO and UNICEF (United Nations Children’s Fund) have drawn up a strategy for a two-step immunisation for children.

The first, to be applied when the child is nine months, forms part of the routine immunisations provided by national health systems. The second vaccination is administered when supplementary immunisation activities take place, every three or four years, to ensure that all children are protected from the virus.

Through this two-pronged strategy, in place since 2000 in Botswana, Lesotho, Malawi, Namibia, South Africa, Swaziland and Zimbabwe, measles-related deaths were dramatically reduced, said Hersh.

The WHO predicts that appropriate implementation of plans like this could prevent 2.3 million childhood deaths in Africa over the next decade.

Guiding the international health agencies are what are known as the Millennium Development Goals, established by the United Nations in 2000, which include reducing infant mortality (children five and younger) to a third of the 1990 rate by the year 2015.

And more specifically, a special session of the UN General Assembly on children, held last year, issued a call to reduce measles-related deaths in 2005 to half the number recorded in 1999.

Hersh said the immunisation experience in the Americas should serve as a model. So far this year, only 18 measles cases have been reported in that hemisphere, and all originated in Eastern Europe, Asia-Pacific or the Middle East.

The WHO and UNICEF calculate that an additional 200 million dollars would be needed to implement the two-pronged immunisation strategy over the next three years.

The two UN agencies plan to carry out the immunisation campaign in the 45 countries where approximately 95 percent of the deaths related to measles occur.

The funds requested by the two institutions would cover injection materials, refrigeration equipment, transportation and personnel costs.

With these resources, says Hersh, the effort could cover routine vaccinations as well as the supplementary applications.