August 17, 2010 / 12:19 PM / 10 years ago

ANALYSIS-Measles complacency allows deadly surge in Africa

* Measles outbreaks in Africa are the worst for years

* Rising death toll shows what happens when guard is dropped

* Funding gap of $59 million must be closed to halt spread

By Kate Kelland, Health and Science Correspondent

LONDON, Aug 17 (Reuters) - The worst outbreaks of measles in years are infecting thousands and killing hundreds across Africa and offer tragic evidence of what happens when health authorities drop their guard on this highly contagious disease.

Health experts say dramatic success in the past decade in boosting global measles vaccination cover and cutting death rates has led to dangerous levels of complacency in some countries, and policy focus and funds have drifted away.

Even mothers — who until recently in some of the worst hit countries didn’t even name their children until they had survived measles — have been lured into a false sense of security, believing the disease has been beaten and they no longer need to bother to visit clinics for immunisations.

About 164,000 people died from measles in 2008, down 78 percent from 733,000 in 2000, according to the Measles Initiative, which groups organisations like the United Nations children’s fund (UNICEF) and the World Health Organisation.

But UNICEF fears the combined effect of decreased political and financial commitment to measles could reverse the gains, resulting in an estimated 1.7 million measles-related deaths globally between 2010 and 2013.

“Measles is so infectious, and given a little space it will spread really fast,” Andrea Gay, director of children’s health at the United Nations Foundation, told Reuters.

Africa is already experiencing some of its largest and most deadly measles outbreaks in years and more than 1,400 people, many of them young children, have died so far this year.

The African death toll is so far relatively small compared with India, which accounted for around 75 percent of child deaths from measles in 2008, but the risk is that continued complacency will allow this preventable virus to spread rapidly.

According to the WHO, more than 28 countries in Africa have suffered outbreaks of measles this year. Some of the worst hit are Lesotho, Malawi, Namibia, South Africa, Zambia and Zimbabwe.

Health officials in Malawi say the viral disease has killed 197 people and infected 77,000 since January — the highest numbers recorded there in the past decade.


Edward Hoekstra, a New York-based specialist with UNICEF’s Global Measles Programme said experts’ greatest fears — that the success against the disease could be reversed when efforts to keep it at bay lapse — are already starting to be realised.

“In the past in Africa, every mother knew about measles. They knew it killed children. Sometimes they wouldn’t even name their children until after they had survived measles,” he said in a telephone interview. “But now they don’t see it so much any more and there has been a drop in demand (for vaccinations).”

Lapses in vigilance about measles are not confined to Africa — outbreaks of the disease have been recurring in the United States, Britain and other rich nations where suspicions about possible side-effects from combination vaccines led to significant drops in coverage rates in recent years.

In Africa’s poorest nations, where victims may be malnourished or have weakened immune systems, measles can quickly become a killer.

In 2009, more than 2.4 million children in eastern and southern Africa, about 20 percent of all children under one year, were not being reached by routine immunisation, according to the United Nations.

With the death toll on the rise, Malawi’s health ministry has embarked on a major vaccination campaign, focusing on rural areas where 80 percent of its 13 million population lives.

It costs less than $1 to vaccinate a child against measles, and two doses of the jab are required for full protection.

To get coverage rates above the 90 percent rate needed to effectively conquer the disease, the WHO advises high-risk countries to conduct national vaccination sweeps every three years to cover those who missed out on jabs as babies.

Experts say the “out of sight, out of mind” mentality is also affecting international donors — particularly when health aid funding is being squeezed by a global economic downturn. The Measles Initiative is facing a $59 million shortfall for 2010.

“What’s frustrating is that we’re only talking about around 50 million dollars or so — that’s really a small amount on the global health agenda,” said Hoekstra. (Editing by Nina Chestney)

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