Progress Toward Regional Measles Elimination — Worldwide, 2000–2020

Abstract

In 2012, the World Health Assembly endorsed the Global Vaccine Action Plan,* with the objective of eliminating measles in five of the six World Health Organization (WHO) regions by 2020 (1). The Immunization Agenda 2021-2030 (IA2030) uses measles incidence as an indicator of the strength of immunization systems. The Measles-Rubella Strategic Framework 2021-2030 and the Measles Outbreaks Strategic Response Plan 2021-2023** are aligned with the IA2030 and highlight robust measles surveillance systems to document immunity gaps, identify root causes of undervaccination, and develop locally tailored solutions to ensure administration of 2 doses of measles-containing vaccine (MCV) to all children. This report describes progress toward World Health Assembly * The Global Vaccine Action Plan is the implementation plan of the Decade of Vaccines, a collaboration between WHO; UNICEF; the Bill and Melinda Gates Foundation; the National Institute of Allergy and Infectious Diseases; the African Leaders Malaria Alliance; Gavi, the Vaccine Alliance; and others to extend the full benefit of immunization to all persons by 2020 and beyond. In addition to 2015 targets, it also set a target for measles and rubella elimination in five of the six WHO regions by 2020. https://www.who.int/teams/immunizationvaccines-and-biologicals/strategies/global-vaccine-action-plan Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographic area for 12 months in the presence of a high-quality surveillance system that meets targets of key performance indicators. Immunization Agenda 2030 is the global vision and strategy to extend the benefits of vaccines to everyone, everywhere, developed by immunization stakeholders and endorsed by the World Health Assembly in 2020. https:// www.who.int/teams/immunization-vaccines-and-biologicals/strategies/ia2030 The Measles and Rubella Strategic Framework 2021-2030 aims to provide high-level guidance for developing regional and national strategies and operational plans. It was developed through a broad consultative process that generated feedback on achievements and major shortfalls in measles and rubella control over the past decade and defined strategic pivots and focus areas for the next decade. It is meant to serve as a disease-specific strategy under the IA2030 structure, and it aligns with other important strategy documents, including WHO's Thirteenth General Programme of Work 2019-2023; the UNICEF Immunization Roadmap 2018-2030; and Gavi, the Vaccine Alliance's 2021-2025 strategy. The Measles and Rubella Strategic Framework 2021-2030 envisions "a world free from measles and rubella." https://www.who.int/ publications/i/item/measles-and-rubella-strategic-framework-2021-2030 milestones and measles elimination objectives during 2000-2020 and updates a previous report (2). During 2000-2010, estimated MCV first dose (MCV1) coverage increased globally from 72% to 84%, peaked at 86% in 2019, but declined to 84% in 2020 during the COVID-19 pandemic. All countries conducted measles surveillance, although fewer than one third ** The Measles Outbreaks Strategic Response Plan 2021-2023 envisions a world in which all countries are equipped with robust measles outbreak prevention, preparedness, and response systems and contains four objectives: 1) improved coordination mechanisms for measles outbreak preparedness and response; 2) expanded vaccination efforts in vulnerable communities through resource mobilization for risk-based national plans in countries that are not eligible for Gavi support; 3) enhanced national capacity for outbreak preparedness in priority countries (e.g., planning, detection, readiness for investigation, and response), including robust surveillance; and 4) improved timeliness and effectiveness of investigation and response to measles outbreaks, including detection, root cause analysis to identify programmatic gaps to prevent future outbreaks, after action reviews and recovery. https://apps.who.int/iris/handle/10665/340657

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