The recent meeting of World Health Organization (WHO) South-East Region nations saw a commitment issued to eliminate measles and rubella by 2023.
The 72nd Session of the WHO Regional Office for Southeast Asia (WHO-SEARO), which took place in Delhi, saw member countries pledge to increase immunisation rates in order to boost herd immunity against the diseases. Herd immunity refers to the stage where a sufficient number of people are immunised against a disease that those who are not immunised enjoy a degree of protection against said disease due to the limited capacity of the disease to spread.
Of the WHO-SEARO member states, measles elimination has been accomplished in Bhutan, Maldives, North Korea, Sri Lanka, and Timor-Leste and rubella has been controlled in Bangladesh, Bhutan, Maldives, Nepal, Sri Lanka, and Timor-Leste. Yet, as the WHO noted when Sri Lanka eliminated measles earlier this year, “of the 37 million children born in the Region every year, eleven percent are missing out on basic vaccines during their first year of life.”
This is painfully true of India, where 2.9 million children have missed out the measles vaccine in the past eight years. India is home to the second highest number of children unvaccinated against measles in the world, behind only Nigeria. This makes the prospect of elimination by 2020 in line with regional and national targets a long shot, despite measles vaccination being covered under the Universal Immunisation Programme (UIP). According to the WHO, India accounts for one-third of measles deaths worldwide and leads the world in cases.
Prime Minister Narendra Modi has previously pledged to ensure that 405 million Indian children would receive the measles-rubella vaccine by 2019 and India has made significant progress in the past decade with measles vaccination efforts. Between 2010 and 2013, the lives of between 41,000 and 56,000 children were saved through measles immunisation.
However, a host of factors ranging from misinformation-fuelled vaccine hesitancy to difficulty reaching remote populations threatens progress against the disease. Indeed, India reported a dramatic resurgence of cases of both measles and rubella in the first quarter of 2019 as every region of the world saw measles infections spike. In 2018, India was one of ten countries home to sixty percent of the world’s 19.4 million infants who did not receive routine immunisation benefits.
The WHO-SEARO countries have laid down a roadmap for achieving measles elimination within the coming years. What is needed in India is political will to achieve herd immunity through sustained campaigns; robust rebuttal of anti-vaccine misinformation; and adequate provision of healthcare services so that historically underserved populations can benefit. Otherwise a disease that has long plagued the country’s children will continue its scourge.