Global Overview of Measles Rubella 11 th Annual
Global Overview of Measles & Rubella 11 th Annual Meeting The Measles Initiative Washington, DC 18 -19 th September, 2012
Major causes of annual under 5 yrs 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 1 st and 2 nd dose Measles delivery various strategies Number of doses of measles vaccine administered, by delivery strategy, 2000 -2010 Measles Initiative 4| 1 billion vaccinated as of July 2011 1 st routine dose: WHO/UNICEF coverage estimates, The World Population Prospects New York, 2011. 2 nd routine dose: WHO/UNICEF Joint reporting form, (not all countries report 2 nd dose). SIA dose; : WHO SIA database, July 2011 (Provisional data)
Measles and other interventions supplementary activities, 2011 *OPV+Vit. A+Deworming+Mealses Vitamin A – 12 De-worming – 10 Bed nets – 2 OPV – 16 Other interventions -5 WHO; August 2012
Annual Number of Reported Measles Cases and 1 st Dose Measles Vaccination Coverage, Worldwide, 1980 -2011 2015 Target 6| 84%
Reduction in Estimated Measles Deaths by WHO Region 2000 to 2010 26% 100% 87% 79% 85% 76% 74% 78% 2010 reduction goal (90%) 7| 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 8|
India 14 states with MCV 1 < 80% are implementing measles SIAs Phase 1 (45 districts covered) Phase 2 (157 districts) Remaining (159 districts) 17 states with MCV 1 coverage ≥ 80% introduced a routine second dose by August 2011. Target Vaccinated pop (millions) Coverage Phase-1 13. 8 12. 1 88% Phase-2 42. 9 28. 6 67%* Phase-3 72. 7 Planned -- Total 129. 4 40. 7* -- * Phase-2 campaigns ongoing; data as on 23 Jan 2012. 9| Source: Based on target population available with Go. I
Measles and Rubella Elimination Goals by WHO Region, February 2012 Americas, Europe, E. Mediterranean, W. Pacific, Africa have measles elimination goals Americas and Europe have rubella elimination goals 2015 2000 2015 2020 10 | 2012 SEAR: 95% Mortality Reduction by 2015
Challenges 1: Communication Political advocacy, mobilizing decision makers Point of service promotion Inter -personal communication Targeted selling Volunteer Social Mobilization Networks Branding, advertising & Researched & Evidenced multipronged communication: Experience from GPEI ‘edu-tainment’ with national, provincial and community mass media Community engagement Meetings, forums, film showings and events COMBI Star adapted for polio eradication
Challenges 2: Weak Immunization Systems Measles 1 st dose coverage among infants, 2010 l 1 st dose: – 67 Countries have MCV 1 coverage < 90% l 2 nd dose ( routine ): – 54 countries do not have routine 2 nd dose l Campaigns: <50% (2 countries or 1%) 50 -79% (41 countries or 21%) 80 -89% (24 countries or 12 %) >=90% (126 countries or 66%) 12 | – Variable quality
Challenges 3: Some set backs in Africa l 4 -fold increase since 2008 l Large outbreaks in Burkina Faso (2009), S. Africa (2010), and DRC (2011) l Outbreaks in drought affected Horn of Africa – High case-fatality 13 | 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) 14 |
Summary l Achievements – – 1 st dose coverage up to 85% 1 billion doses delivered in campaigns 2 / 3 reduction in cases 3 / 4 reduction in deaths l Challenges – Catch - up in India; Outbreaks in Africa; Weak systems l New Strategic Plan, 2012 – 2020 – Addressing rubella together with Measles – Taking the Initiative towards achieving regional goals l More Harambee 15 |
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