By Lauren Tailor
What is measles and why is it so contagious?
Measles is an extremely contagious respiratory viral infection that was the cause of major epidemics and 2.6 million deaths per year globally before the development of a vaccine in 1963. With a viral reproduction number of 12-18 (for comparison, Ebola has a reproduction number of 1.5-2.5), measles is the most infectious vaccine-preventable disease in the world. In fact, 95% of the community must be vaccinated in order for herd immunity to protect against disease within a region. Exposure to the virus may present as mild symptoms (high fevers, runny nose, cough, etc.), but can additionally include serious and fatal complications such as blindness, encephalitis, severe diarrhea, pneumonia, and death. Immunization activities for measles were restricted due to coronavirus, with healthcare workers focusing on COVID-19 campaigns. As such, the WHO and UNICEF are declaring an emergency call to action for measles prevention and response.
Why are the WHO and UNICEF declaring an emergency call to action?
While a safe and highly effective vaccine exists, many individuals in low-income nations remain unvaccinated. In 2019, over 850,000 cases of measles were reported globally, which is the highest number in two decades. In addition, the WHO predicts that more child deaths in Africa will be caused by measles rather than COVID-19. Due to the COVID-19 pandemic, many measles vaccination campaigns were suspended, with some countries falling to vaccination rates of 50%. Risk of contracting COVID-19 and mandatory lockdowns have also decreased vaccination rates even when resources are available. More than 94 million children have missed their measles vaccination as a result of the pause due to COVID-19, which will likely cause massive outbreaks if not mitigated.
“We cannot allow the fight against one deadly disease to cause us to lose ground in the fight against other diseases. Addressing the global Covid-19 pandemic is critical. However, other deadly diseases also threaten the lives of millions of children in some of the poorest areas of the world,” said Henrietta Fore, UNICEF Executive Director. “That is why today we are urgently calling for global action from country leaders, donors and partners. We need additional financial resources to safely resume vaccination campaigns and prioritize immunisation systems that are critical to protect children and avert other epidemics besides Covid-19.”
What are the next steps?
Measles immunization activities have slowly restarted in some countries, but the costs of these campaigns have increased significantly due to the necessary COVID-19 safety measures that must be in place for healthcare workers and community members. A Measles Outbreak Strategic Response plan was created this year to help countries improve their outbreak preparedness. Thanks to this plan, Ethiopia organized a campaign to vaccinate 14.6 million children in July 2020. The Global Measles Rubella Laboratory Network is also involved in helping to provide laboratory space, equipment, staff, and tests necessary for COVID-19 testing. This network is the largest WHO-coordinated laboratory network, with facilities in almost all of the 194 WHO Member States.
In order to operate these services and improve measles vaccination campaigns, the WHO and UNICEF estimate an additional $255 million USD will be needed over the next three years.The WHO and UNICEF propose that this funding be used to build urgent vaccination campaigns and fill the gaps within currently operating systems. This funding for a global measles vaccine and immunization strategy is detailed in the “Immunization Agenda 2030”, which highlights the weaknesses in the current immunization systems. While several gaps in the immunization structure exist throughout the affected nations, the majority of this funding will be focused on the 45 countries at highest risk for outbreaks.
Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, notes that, “unlike with Covid, we have the tools and knowledge to stop diseases such as polio and measles. What we need are the resources and commitments to put these tools and knowledge into action. If we do that, children’s lives will be saved.”