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Progress in the fight against measles has been set back more than a decade after 22 million babies missed their measles vaccinations last year, leading health bodies have warned.
Measles is one of the world’s most contagious human viruses, killing more than 60,000 people in 2020, but is almost entirely preventable.
Although cases of the disease fell more than in previous years, the risk of outbreaks is mounting as COVID-19 disrupts global healthcare, says a report by the WHO and US Centers for Disease Control and Prevention (CDC).
“For measles, there is no standing still. Either you’re moving forward or you’re falling backwards. Any pause and it will resurge.”
Natasha Crowcroft, WHO senior advisor for measles and rubella
Missed vaccinations, combined with declines in measles surveillance and reporting, have created “dangerous conditions for outbreaks to occur”, the health institutions said in a joint report.
Natasha Crowcroft, WHO senior technical advisor for measles and rubella, who co-authored the report, said: “The world has now been set back at least a decade in progress towards measles elimination.
“We are very worried by what 2022 may bring with increasing malnutrition and increasing risk of measles creating a perfect storm for large outbreaks with severe and tragic consequences for children.”
She warned that countries must “act now” to strengthen disease surveillance systems and close immunity gaps, before travel and trade return to pre-pandemic levels.
In the last 20 years, the measles vaccine is estimated to have averted more than 30 million deaths globally.
Estimated deaths from measles dropped from over a million in 2000 to 60,700 in 2020.
The COVID-19 pandemic caused significant disruptions to immunisation services and changes in health-seeking behaviours in many parts of the world, even though measures to mitigate the pandemic, like hand washing, mask-wearing and social distancing, also reduced the spread of measles virus, according to the report.
More than 22 million infants worldwide missed their first dose of measles vaccine in 2020 — 3 million more than in 2019 — making it the largest increase in two decades, the report said. Only 70 per cent of children received their second dose, well below the 95 per cent coverage needed to prevent the virus from spreading, it added.
While there was a decrease in reported measles cases of more than 80 per cent, it was likely linked to a deterioration in surveillance, with the lowest number of specimens sent to laboratories in over a decade, the report suggests.
“There is no point in creating a problem to solve another,” Crowcroft said in reference to prioritising COVID-19 over other disease emergencies.
“We have to maintain a focus on measles at the same time as COVID-19. For measles, there is no standing still. Either you’re moving forward or you’re falling backwards. Any pause and it will resurge.”
Major measles outbreaks occurred in 26 countries last year with low- and middle-income countries continuing to bear the biggest burden. Sub-Saharan Africa accounted for 18 of the 26 most affected countries, according to the report.
At the same time, measles vaccination campaigns in 23 countries, originally planned for 2020, were postponed because of the COVID-19 pandemic, it found.
Kevin Cain, CDC’s global immunisation director, said the combination of vaccine gaps, measles outbreaks, and declines in detection and diagnostics, increases the likelihood of measles-related deaths and serious complications in children.
“Countries and global health partners must prioritise finding and vaccinating children against measles to reduce the risk of explosive outbreaks and preventable deaths from this disease,” he urged.
Peter Ofware, Kenya country director at health and human rights organisation HealthRight International, said countries in Sub-Saharan Africa which are disproportionately affected by the disease must adopt a multi-sectoral approach to get vaccination campaigns back on track.
“Countries may have to get into partnerships with development partners and even review their budgets to re-direct resources towards vaccination campaigns,” Ofware said.
Kate O’Brien, director of the WHO’s department of immunisation, vaccines and biologicals, acknowledged it was critical for countries to vaccinate as quickly as possible against COVID-19. “But this requires new resources so that it does not come at the cost of essential immunisation programmes,” she added.
“Routine immunisation must be protected and strengthened, otherwise we risk trading one deadly disease for another.”
This piece was produced by SciDev.Net’s Global desk.