South-east Asian nations pledge to eliminate measles by 2020

Doctors say it may hamper people from acquiring natural immunity

By Kundan Pandey
Published: Sunday 15 September 2013

At the 66th session of the World Health Organization (WHO) South-east Asia Region in New Delhi on Friday, the 11 member countries committed themselves to eliminating measles and controlling rubella and congenital rubella syndrome (CRS) by 2020. WHO estimates that US $ 800 million would be required to achieve this target in the set time frame. In order to reach the goal of measles elimination and rubella control, governments will need to achieve and maintain 95 per cent population immunity against these diseases within each district through routine immunisation and/or supplementary campaigns. The administration of a combined measles rubella vaccine can eliminate both diseases cost effectively,” said Samlee Plianbangchang, WHO’s Regional Director for South-East Asia.

Anuradha Gupta, joint secretary with India’s Union ministry of health, said that surveillance system is most important in achieving the target. WHO also said that countries will need to develop and sustain a sensitive and timely case-based measles and rubella/CRS surveillance system. The regional network of accredited measles and rubella laboratories needs to be expanded and strengthened for this.

Right move?
A paediatrician in Delhi, however, said that this effort will create problems for natural immunity a human being develops gradually. He said that rubella is such a disease, which comes and goes but nobody notices it, and CRS which is serious disease has not been monitored in country so far, he said, adding that the country has committed itself for immunisation of its children without having complete picture about its prevalence. “I suggest that the health authorities first get picture of prevalence rate of such diseases and if necessary, vaccinate people only after 18 years of age, so that they can get natural immunity,” he added.

Rubella is a contagious viral disease, which occurs most often in children. The virus is transmitted via the respiratory route, and symptoms usually appear two to three weeks after exposure. In children, the disease is usually mild, with low fever, nausea and transient rashes. Adults may develop arthritis and painful joints. CRS is a more serious. When a pregnant woman infects her children during the disease, it is termed as CRS and can cause multiple defects, particularly to the brain, heart, eyes and ears. There is no specific treatment for rubella. The disease can be prevented by immunisation.

Data needed

Similarly, country-wise data on measles is also not available. In the statement, WHO officials informed that over 70,700 children died of measles in 11 countries of WHO South-East Asia Region in 2011. This constitutes about 45 per cent of global measles deaths.

Gupta informed that 118 million children have been successfully immunised with measles second dose. Counting measure challenges, she said that all such programmes need human resource. In polio, there was oral vaccine so large number of people could be engaged and achieved the target, but in measles, the vaccine is injected for which skilled people are required for administering vaccine. However, states and Centre, both are extremely confident of reaching the target, she said.

Plianbangchang informed that between 2000 and 2011, countries of this region have already achieved a 63 per cent decline in the measles incidence rate. WHO, SEARO coordinator, Arun Thapa, said that countries’ efforts in this region have led to a 48 per cent decline in measles deaths between 2000 and 2011.

Although the current rate of progress in the region may not be fast enough to achieve the target of reducing measles deaths by 95 per cent by 2015 as mandated by the 63rd World Health Assembly, the stage is now set for acceleration of measles and rubella control strategies. If implemented, this would allow the region to achieve the 2020 elimination goal, he added.

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