Intervention by Medecins Sans Frontieres
126th WHO Executive Board, Agenda Item 4.14 Global Eradication of Measles
Speaker: Katy Athersuch, Medical Innovation & Access Policy Adviser
Thank you Chair,
The prevention and treatment of measles is one of the core activities of Médecins Sans Frontières. Despite impressive progress towards global control, MSF is concerned that controlling measles remains a major challenge in many countries. We therefore welcome the call of the WHO Secretariat for new, ambitious measles targets for 2015.
In 2008, MSF vaccinated more than 1.9 million children in response to outbreaks and treated more than 32,000 measles cases. As outbreaks continue, achieving the Secretariat’s measles targets for 2015 will require additional investment and strong political will. We believe there are a number of focused and practical steps that Member States can now take so that eradication can become a more realistic target.
We share the concerns of the Secretariat that adequate programme monitoring and disease surveillance are critical to assessing progress and eventually asserting true elimination. The importance of the evaluation of vaccination coverage by independent surveys is critical, as their outcomes are necessary in order to adapt activities appropriately, and to evaluate the risks posed to specific populations.
For routine activities, in accordance with the Global Immunization Vision Strategy, the enlargement of the target group to five years of age is an important step, especially in contexts where cases or outbreaks occur.
In addition to strengthening routine immunisation, supplementary activities are still needed in the many areas where coverage remains below 90% for the first dose.
Overall, we see the need to adapt age group criteria and ensure an adapted timing between campaigns.
Our biggest concern is that major measles outbreaks still occur. Evidence shows that it is never too late in an outbreak to use vaccination. This needs to be translated into action. One key step when there is high risk for outbreaks to spread is the extension of the target group for reactive immunisation. In order to encourage care-seeking behaviour during an outbreak it is also important that treatment be free of charge. In addition, any outbreak response provides an opportunity to provide the second dose to some and to vaccinate with additional antigens, thereby increasing overall EPI coverage. We suggest Member States give WHO the additional resources necessary to assist countries in outbreak responses.
Finally, in order to make progress in the most difficult contexts, new vaccine delivery systems, such as aerosol preparation or needle-free intradermal administration would bring great advantage, especially for difficult-to-reach populations. Their introduction should be prioritised and accelerated.
Thank you Chair.