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Global Overview of Measles & Rubella. 11 th Annual Meeting The Measles Initiative Washington, DC 18-19 th September, 2012. Major causes of annual under 5yrs child mortality: 1990-2010. 1990: 12.1 million. 2000 : 9.6 million. 2008: 8.8 million. 2010 : 7.6 million.
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Global Overview of Measles & Rubella 11th Annual Meeting The Measles Initiative Washington, DC 18-19th September, 2012
Major causes of annual under 5yrs child mortality: 1990-2010 1990: 12.1 million 2000 : 9.6 million 2008: 8.8 million 2010 : 7.6 million Source: Van den Ent et al, J Infect Dis Suppl July 2011 Source: Li, Liu, at all The Lancet 379, June 9, 2012):
Estimated measles deaths down by three - quarters, 2000 - 2010 74% 2015 Target
Trends in 1st and 2nd dose Measles delivery various strategies Number of doses of measles vaccine administered, by delivery strategy, 2000-2010 Measles Initiative 1 billion vaccinated as of July 2011 1st routine dose: WHO/UNICEF coverage estimates, The World Population Prospects New York, 2011. 2nd routine dose: WHO/UNICEF Joint reporting form, (not all countries report 2nd dose). SIA dose;: WHO SIA database, July 2011 (Provisional data)
Measles and other interventions supplementary activities, 2011 Vitamin A – 12 De-worming – 10 Bed nets – 2 OPV – 16 Other interventions -5 *OPV+VitA+Deworming+Mealses WHO;August2012
Annual Number of Reported Measles Cases and 1st Dose Measles Vaccination Coverage, Worldwide, 1980-2011 84% 2015 Target
Reduction in Estimated Measles Deaths by WHO Region 2000 to 2010 26% 100% 87% 79% 85% 76% 74% 78% 2010 reduction goal (90%) Source: WHO/IVB, November 2009
Pareto-Juran principle 20% of the work (the first 10% and the last 10%) consume 80% of your time and resources
India Phase 1 (45 districts covered) Phase 2 (157 districts) Remaining (159 districts) 14 states with MCV1 < 80% are implementing measles SIAs 17 states with MCV1 coverage ≥ 80% introduced a routine second dose by August 2011. * Phase-2 campaigns ongoing; data as on 23 Jan 2012. Source: Based on target population available with GoI
Measlesand RubellaElimination Goalsby WHO Region, February 2012 Americas, Europe, E. Mediterranean, W. Pacific, Africa have measles elimination goals Americas and Europe have rubella elimination goals 2015 2015 2000 2010 2015 2012 SEAR: 95% Mortality Reduction by 2015 2020
Challenges 1: Communication Political advocacy, mobilizing decision makers Branding, advertising & ‘edu-tainment’ with national, provincial and community mass media Point of service promotion Inter-personal communication Researched & Evidenced multi-pronged communication: Experience from GPEI Community engagement Meetings, forums, film showings and events Targeted selling Volunteer Social Mobilization Networks COMBI Star adapted for polio eradication
Challenges 2: Weak Immunization Systems <50% (2 countries or 1%) 50-79% (41 countries or 21%) 80-89% (24 countries or 12 %) >=90% (126 countries or 66%) Measles 1st dose coverage among infants, 2010 • 1st dose: • 67 Countries have MCV1 coverage < 90% • 2nd dose ( routine ): • 54 countries do not have routine 2nd dose • Campaigns: • Variable quality
Challenges 3: Some set backs in Africa • 4-fold increase since 2008 • Large outbreaks in Burkina Faso (2009), S. Africa (2010), and DRC (2011) • Outbreaks in drought affected Horn of Africa • High case-fatality Weekly Epidemiological Record (2011) 86:129-135
Historical procurement of Measles and MR vaccine through UNICEF in 2000-2012 and forecasts for 2013-2016 (in doses)
Summary • Achievements • 1st dose coverage up to 85% • 1 billion doses delivered in campaigns • 2 / 3 reduction in cases • 3 / 4 reduction in deaths • Challenges • Catch - up in India; Outbreaks in Africa; Weak systems • New Strategic Plan, 2012 – 2020 • Addressing rubella together with Measles • Taking the Initiative towards achieving regional goals • More Harambee