5-Sep-2019: WHO South-East Asia Region sets 2023 target to eliminate measles, rubella

Member Countries of WHO South-East Asia Region resolved to eliminate measles and rubella by 2023, to prevent deaths and disabilities caused by these highly infectious childhood killers diseases.

The new target to eliminate both the diseases will leverage the existing momentum and strong political commitment which is being demonstrated through unprecedented efforts, progress and successes in recent years,” said Dr Poonam Khetrapal Singh, Regional Director WHO South-East Asia, as a resolution to eliminate the two diseases was adopted at the Seventy Second Session of WHO Regional Committee for South-East Asia.

Measles elimination and rubella control has been a regional flagship priority since 2014. Five countries have eliminated measles – Bhutan, DPR Korea, Maldives, Sri Lanka and Timor-Leste. Six countries have controlled rubella - Bangladesh, Bhutan, Maldives, Nepal, Sri Lanka and Timor-Leste.

To achieve the new targets, the Member countries resolved to strengthen immunization systems for increasing and sustaining high level of population immunity against measles and rubella at both national and sub-national levels.

The resolution calls for ensuring a highly sensitive laboratory supported case-based surveillance system – better evidence for appropriate planning and response. It also emphasizes on preparedness for outbreak response activities for measles and rubella.

All countries pledged to mobilize political, societal and financial support to ensure interruption of transmission of indigenous measles and rubella virus by 2023.

The Member countries adopted a “Strategic Plan for Measles and Rubella Elimination 2020-2024” that lays down the road map and focus areas to achieve the elimination targets in the Region.

Eliminating measles will prevent 500,000 deaths a year in the Region, while eliminating rubella/ CRS would avert about 55,000 cases of rubella and promote health and well-being of pregnant woman and infants.

The drive against measles and rubella/CRS gathered crucial momentum after 2014, when ‘Measles Elimination and Rubella/CRS Control by 2020’ was declared one of the eight Flagship Priority programmes for the Region and a Regional Strategic Plan was implemented across the Member States.

There has been a 23% decline in mortality due to measles in the 2014-17 period. Nearly 366 million children have been reached through mass vaccination campaigns with measles-rubella (MR) containing vaccines in the Region since January 2017.

Children in all 11 Member countries have access to 2 doses of measles containing vaccine (MCV) and ten countries have access to rubella-containing vaccine.

The decision to revise the targets of measles and rubella elimination was preceded by several consultations, including during the WHO South-East Asia Regional Immunization Technical Advisory Group meeting in July 2019. The WHO Regional Office for South-East Asia also conducted high-level consultations, in March 2019, with Member States on the feasibility of adopting the new target.

Measles is particularly dangerous for the poor, as it attacks malnourished children and those with reduced immunity. Measles can cause serious complications, including blindness, encephalitis, severe diarrhoea, ear infection and pneumonia while rubella/ congenital rubella syndrome (CRS) causes irreversible birth defects.

11-Nov-2017: Expert Advisory Group on Measles & Rubella commends India on MR vaccination progress
The India Expert Advisory Group on Measles & Rubella (IEAG-MR) has commended India on the progress of the measles and rubella vaccination campaign, as it reviewed the existing strategies and efforts towards measles elimination and control of rubella during the past two days with Ministry of Health & Family Welfare. The expert member group concluded that ‘the country is on the right track’. The experts commended the strong leadership of the Government of India, as well as the ownership of the state governments to ensure that every child is vaccinated against these two diseases.

The expert group consisting of national and international experts complimented India on the growing trend in MCV (measles containing vaccine) coverage, and the significant reduction in MCV-1st dose and MCV-2nd dose dropout rate which declined from 44% to 13%. There has also been a reduction of DPT booster dose and MCV2 missed opportunities from 43% to 7% . The group has advised for the MR vaccination campaign to cover the whole country by 2018. Presentably 13 states have been covered by the vaccination campaign. The most recent campaigns in Andhra Pradesh and Telangana were reviewed in detail, and the experts complimented both states for excellent performance and their innovations to achieve very high coverage. The Group has recommended to strengthen the surveillance for MR and to expand the MR laboratory network.

UNICEF salutes the Government of India in tackling such a major threat to children’s lives and wellbeing - through a combination of campaigns and the operation Indradhanush. UNICEF as a children’s agency commits to walk the extra mile with the Government of India. India has shown tremendous leadership on advancing measles elimination and rubella control. It sets an important example globally, demonstrating best practices.

Two doses of Measles vaccine fully protect children against measles infection. In the past while the 1st dose coverage was close to 90%, the 2nd dose lagged behind by 45%. Both the MR campaigns and IMI are dramatically reducing this gap.

The Government of India has a smart plan that capitalizes on previous investments for polio eradication by re-tooling existing information systems and resources for measles elimination. Measles surveillance data should continue to be used to identify any areas with children missed by vaccination, thereby contributing to measles elimination efforts in India.

Measles kills an estimated 49,000 children in India each year, which is about 37% of the global deaths due to this disease. India has set an ambitious goal to eliminate measles from the country. Measles Rubella vaccine has been introduced in 13 states. It is planned to expand across the country, covering 41 crore children by the end of 2018.

5-Feb-2017: Health Ministry launches single vaccine for dual protection against measles and rubella as part of Universal Immunization Programme

The Ministry of Health and Family Welfare launched Measles Rubella (MR) vaccination campaign in the country at a function in Bengaluru, here today. The campaign against these two diseases will start from five States/UTs (Karnataka, Tamil Nadu, Puducherry, Goa and Lakshadweep) covering nearly 3.6 crore target children. Following the campaign, Measles-Rubella vaccine will be introduced in routine immunization, replacing the currently given two doses of measles vaccine, at 9-12 months and 16-24 months of age.

Speaking at the launch, Minister of State for Health and Family Welfare, Shri Faggan Singh Kulaste stated that the Government is committed to eradicating Measles and Rubella from the country. “We have taken this as an achievable target. This shall be taken up in a mission mode and rolled out in partnership with States , NGOs and development partners such as WHO, UNICEF, Gates Foundation, Lions Club, IPA, IMA, etc. In the nationwide campaign, the Ministry will reach out to and cover 41 cr children in the age group of 9 months – 15 years,” Shri Faggan Singh said. He urged parents, caregivers, community leaders, teachers, anganwaadi workers and other frontline health workers to become the active part of this campaign.

The MR campaign targets around 41 crore children across the country, the largest ever in any campaign. All children aged between 9 months and less than 15 years will be given a single shot of Measles-Rubella (MR) vaccination irrespective of their previous measles/rubella vaccination status or measles/rubella disease status. MR vaccine will be provided free- of- cost across the states from session sites at schools as well as health facilities and outreach session sites. Measles vaccine is currently provided under Universal Immunization Programme (UIP). However, rubella vaccine will be a new addition. After the completion of the campaign, MR vaccine will be introduced in routine immunization and will replace measles vaccine, given at 9-12 months and 16-24 months of age of child.

Measles is a deadly disease and one of the important causes of death in children. It is highly contagious and spreads through coughing and sneezing of an infected person. Measles can make a child vulnerable to life threatening complications such as pneumonia, diarrhoea and brain infection. Globally, in 2015, measles killed an estimated 1, 34,200 children—mostly under-5 years. In India, it killed an estimated 49,200 children.

Rubella is generally a mild infection, but has serious consequences if infection occurs in pregnant women, causing congenital rubella syndrome (CRS), which is a cause of public health concern. CRS is characterized by congenital anomalies in the foetus and newborns affecting the eyes (glaucoma, cataract), ears (hearing loss), brain (microcephaly, mental retardation) and heart defects, causing a huge socio-economic burden on the families in particular and society in general.

In 2010, an estimated 1,03,000 children were born with CRS (congenital rubella syndrome) globally, of which around 47,000 children, i.e. 46% were in South-East Asia Region. Through implementation of rubella vaccination strategies the incidence of rubella has been substantially reduced in many countries. Although coverage for measles (MCV-1) vaccination is high, the country population immunity is insufficient to stop ongoing MR transmission as evident form surveillance data. Through this campaign, it is aimed to rapidly build up immunity in the susceptible cohort, thereby decreasing the disease burden in the country.

The measles disease burden was brought down by introduction of second dose of measles vaccine in 2010. For this introduction, supplementary immunization Activity (SIA) was conducted in 14 states (2010-13) with less than equal to 80% measles coverage. The remaining states introduced measles second dose directly in routine immunization. However, those gain need to be supplemented, and in order to further reduce the burden, country is going to carry out the Measles-Rubella campaign.

Measles immunization directly contributes to the reduction of under-five child mortality, and with combination of rubella vaccine, will control rubella and prevent CRS in country population. Given the wide target group of the vaccination campaign, schools and educational institutions will play a critical role, and will require partnership from multiple stakeholders at all levels.

10-Jan-2017: Measles-rubella (MR) vaccine to be introduced in February.

Three years after the national vaccine advisory body recommended the introduction of the measles-rubella vaccine (MR) in the Universal Immunisation Programme (UIP), the vaccine is all set to be introduced from next month in five states and Union territories as a part of the basket of preventive medications that every child born in India is entitled to. In addition, from March, Pneumococcal conjugate (pneumococcal pneumonia) vaccine will also become a part of the UIP basket in three other states.

The UIP already has ten vaccines of which measles is one; once MR is introduced, monovalent measles will be discontinued. Both the new vaccines will be launched by Health Minister J P Nadda in separate programmes. While the MR vaccine will be introduced in Goa, Karnataka, Lakshadweep, Puducherry and Tamil Nadu between February 3 and 4, the pneumonia vaccine will be introduced in Himachal Pradesh and parts of Uttar Pradesh and Bihar from March 17.

Commonly known as German Measles, congenital rubella infection is believed to affect approximately 25,000 children born in India every year. Symptoms of the infection can include cataracts and deafness. It can also affect the heart and the brain.