Measles report shows how setting reachable goals can guide progress, but not fast enough

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The report on outcomes of measles elimination efforts released last week by the World Health Organization and the U.S. Centers for Disease Control and Prevention shows, as its title suggests, progress.

Between the first year of this century and 2017, according to the report, Progress towards regional measles elimination, access to the first dose of the vaccine against measles overall increased by 13 percent. Incidence dropped, in concert, even more significantly, by 83 percent from 145 cases per million people to 25, and reported deaths by 80 percent — from more than half a million in 2000 to 109,638 in 2017. Increased access to and uptake of vaccines played a role in preventing an estimated more than 21 million deaths, mostly in African countries, and in countries supported by Gavi, the Vaccine Alliance.

Still, although vaccines are acknowledged to be among the most efficient and effective tools that modern medicine has to offer, more than 20 million children worldwide went unvaccinated. Most of them, the report notes, were in countries with stretched resources, facing multiple daunting public health and resource challenges: Nigeria, India, Pakistan, Indonesia, Ethiopia and Angola. But, the report also notes, stalled progress in vaccine access and uptake has been global over the last two years, and has played a role in the resurgence of measles in European countries that had neared, and even reached the goal of eliminating the virus. From 2016 to 2017, the report points out, measles incidence increased worldwide.

Surveillance for the disease remains a weakness, the report notes. While 97 percent of countries worldwide carried out some surveillance, and 98 had access to reliable laboratory testing for the virus, measures of effective surveillance found that fewer than half of the countries could show they had produced reliable data. In addition, the report concludes, outbreaks still need to be followed by a search for reasons that one of the efficient, effective tools in modern medicine is not reaching everyone who could benefit from it.

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