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Update on Progress toward Measles Situation in EMR September 2008

Update on Progress toward Measles Situation in EMR September 2008. Dr B. Naouri VPI/DCD/EMRO. Overview. Current situation Status of implementation of measles elimination strategies Challenges Future Plans. Measles Elimination in EMRO. Regional Committee Resolution, 1997

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Update on Progress toward Measles Situation in EMR September 2008

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  1. Update on Progress toward Measles Situation in EMR September 2008 Dr B. Naouri VPI/DCD/EMRO

  2. Overview • Current situation • Status of implementation of measles elimination strategies • Challenges • Future Plans

  3. Measles Elimination in EMRO Regional Committee Resolution, 1997 Eliminate measles in all member states of the Eastern Mediterranean region by 2010

  4. Current situation

  5. Measles Mortality in EMR 1999 - 2006 120,000 106,000 2005 target: 50% reduction compared to1999 103,800 100,000 93,600 80,000 70,000 68,700 Deaths 60,000 2010 target (GIVS): 90% reduction 47,600 39,000 40,000 34,000 20,000 0 1999 2000 2001 2002 2003 2004 2005 2006 EMR target: elimination, 2010 Year

  6. Status of implementation of measles elimination strategies

  7. Strengthening routine infant immunization95% coverage MCV1 in all districts

  8. MCV1 Coverage in countries of the EMR 2007 MCV1: 67% in 1990 85% in 2007 Palestine Bahrain More than 90% (14 countries) 90% is not achieved in all districts 80% to 90% (2 countries) 50% to 79% (5 countries) Less than 50% (1 country & S. Sudan)

  9. 2nd opportunity of Measles Immunization Palestine Bahrain 18 countries with routine second dose 4 countries with one dose and follow-up SIAs

  10. Distribution of the 2.7 million children who did not receive measles vaccine, in 2007, EMRO

  11. Supplemental Immunization activities

  12. Catch-up campaigns • All countries have conducted catch-up campaign • 1994-2008: 220 M children were immunized through catch-up campaigns • Repeated campaigns • 2008 • Pakistan, Morocco, Lebanon • Planned: Egypt

  13. Reported Measles/Rubella Cases in Egypt (1996 – mid 2008) MMR Rubella outbreak Lab

  14. MR Campaign Phase 1, 2008BudgetShort Fall (21%) SM MP UNICEF 5% Budget short fall 21% ($ 4.3 million) SIA’s CM Training Egypt (74%) Vaccine and Logistics

  15. Planned SIA, EMRO, 2008-2009

  16. Measles Case-Base Surveillance

  17. Case-based Measles Surveillance 2008 Palestine Bahrain Nationwide case-based measles surveillance with laboratory investigation (18) Case-based needs to be strengthened (4 & South Sudan)

  18. Capacity of Measles/Rubella Laboratory Network in the EMR, 2008 Palestine Bahrain All Countries have NML serology (22) Countries with serologyplus virus isolation (12) Utilizing Polio infrastructure Regional Reference Laboratories Sub-Regional Reference Laboratories

  19. Challenges

  20. Measles outbreaks EMRAugust 2008 • Iraq: 3322 cases 74% non-immunized • Afghanistan: 20 outbreaks, 5-30 cases/outbreak • South Sudan: 147 cases, 9 deaths

  21. Challenges (cont.) • Repeated catch-up campaigns (Egypt) • Support to non GAVI countries • Implementation of an Integrated Disease Surveillance System • Weakness of routine immunization programs

  22. Future Plans (2009) • Achieve and maintain a high routine measles vaccination coverage • Implementation of RED strategy • Ensure high quality of follow-up SIAs • Strengthening of measles surveillance in all EMR countries by end of 2009 • Regional Guidelines • Guidelines for validation of measles elimination • Assistance to Somalia and South Sudan Special efforts are needed

  23. Thank you!

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