Reaching the 2010 Measles Mortality Reduction Goal-can SEARO get there

1. Reaching the 2010 Measles Mortality Reduction Goal-can SEARO get there? Meeting of the Partners for Measles Advocacy Washington DC, 23-24 September 2008 Dr. Pem Namgyal Regional Adviser, Vaccine Preventable Diseases Immunization and Vaccine Development Department of Family and Community Health, SEARO

2. Regional Strategic Plan 2007-2010 Goal By 2010 reduce the number of estimated measles deaths by 90% in comparison to 2000 Specific objectives 1st dose measles coverage >90%, nationally and >80% coverage in all districts by 2010 Provide a second opportunity for measles immunization by 2010 while achieving >90% coverage Case based measles surveillance within integrated surveillance systems in countries that completed catch-up campaigns Fully investigate all detected/reported measles outbreaks

3. Estimated measles mortality reduced by 26% between 2000 and 2006

4. Add DPRK for second routine dose, add new color for Nepal (catch up campaigns completed and follow up campaigns planned)Add DPRK for second routine dose, add new color for Nepal (catch up campaigns completed and follow up campaigns planned)

6. Cases from Serologically Confirmed Suspected Measles Outbreaks Nepal, 2003-2008 July

7. Cases from Serologically Confirmed Suspected Measles Outbreaks Bangladesh, 2004-2008 July

9. Measles: routine coverage and surveillance in India Measles routine coverage in India is low, but showing progressive improvement Surveillance in general is poor; in six southern states WHO SMO network is supporting the state government to carry out measles surveillance Surveillance needs to be established in other states as well, but who is to do it is the current debate

11. India Technical Advisory Group for Measles Control (ITAGM) In 2007 GoI formed the India Technical Advisory Group for Measles (ITAGM) comprising national and international experts to guide the government on the future steps for measles mortality reduction in India ITAGM held its 1st meeting in September 2007 and put up its recommendations to National Technical Advisory Group on Immunization (NTAGI) NTAGI met on 16 June 2008 endorsed ITAGM recommendations

12. ITAGM � State specific strategies

13. NTAGI Recommendations for Measles control a) UIP second dose (MR): States with >=80% evaluated MCV1 b) Catch-up measles SIA campaigns (9mo-10 YR): States with <80% evaluated MCV1. c) For UP, decision on catch-up SIA after consultation with State Government. d) CFR studies: in selected high burden states. Draft proposal developed, being reviewed e) Expansion of measles surveillance will be done in UP and Bihar and other states with high mortality due to measles for SIA planning and having a baseline.

14. Recommendations of ITAG and regional priorities Implementation of NTAGI recommendations on accelerating measles mortality reduction in India. Most importantly, the 10 states of India that account for 90% of measles mortality need to conduct measles catch-up SIAs as soon as possible. Technical sub-group to develop SEAR regional rubella control policy and providing more comprehensive guidance on implementation of measles control and surveillance. All countries that have completed catch-up campaigns should initiate measles case-based surveillance with laboratory confirmation and fully investigation of all detected/reported outbreaks.

15. Can SEA Region Make it? The answer is Yes if we can get India to accelerate the process The problem is neither financial nor technical The most influential partners and from the highest level need to emphasize to the highest authorities in India the importance of India�s achievement to the regional and global ability to achieve the goal for measles mortality reduction

16. THANK YOU