Push to eliminate measles, rubella continues in the face of challenges
MEMBER countries of the World Health Organisation’s Southeast Asia Region (WHO SEAR) have pledged to carry out the elimination of measles and rubella by 2020 through an extensive vaccination programme.
However, only five out of 11 countries have achieved their vaccination goal, and the growing anti-vaccination movement among parents has presented a challenge.
Thailand’s Department of Disease Control (DDC) is also committed to this goal, but despite a satisfactory rate of measles vaccine coverage in other parts of the country, the ongoing insurgency in the Deep South has created a problem with the vaccination campaign there.
In the Seventieth Session of the Regional Committee of WHO SEAR in Maldives last week, all 11 member states agreed to further push forward the commitment to eliminate measles and rubella. These are both preventable diseases but they kill up to 134,200 children around the world annually, including 54,500 from SEAR countries.
Dr Pem Namgyal, WHO SEAR director, department of family health, gender and life course, said measles is an infectious viral disease that presents with fever and rash. It often occurs in small children and sometime results in respiratory co-infections with bacteria, causing pneumonia, which is usually fatal in small children. Rubella, which is sometimes called German measles, causes similar symptoms but is a greater concern if present in pregnant women, as it can lead to abnormality to the foetus.
Namgyal said that even though these diseases could be prevented by vaccination, many countries in WHO SEAR still failed to promote wideenough vaccine coverage. Any coverage below 95 per cent of the population puts children at considerable risk of catching these preventable diseases.
“It is a prime goal for our region, since the SEAR committee resolution in 2013 to eliminate measles from the region,” he said. “But as per the latest statistics only Maldives, Thailand, Sri Lanka, Bhutan and North Korea have met the goal of 95 per cent measles vaccination coverage.”
Namgyal stressed that for every 325 million more children the measles vaccine reached, 600,000 measles deaths would be avoided.
However, he cautioned that there were still many challenges to be overcome to achieve the total control of measles and rubella infection.
These included expanding the vaccination programme among the vast populations of countries such as India and Indonesia, installing surveillance standards for measles and rubella monitoring, and maintaining strong political commitment and adequate resources to carry out this goal.
“We are also facing a new worrying trend among parents, as some of them refuse to let their children get a vaccination. This will jeopardise the effort of closing the immunity gap in the region as a whole,” he stressed.
“The wide coverage of measles vaccination has played a significant role in reducing the infant mortality rate by 64 per cent since 1990. It was estimated that more than 5.9 million deaths due to measles have been averted due to the global vaccination campaign.”
But an estimated 4.7 million children in SEAR still did not receive measles and rubella vaccinations in 2016.
Meanwhile, DDC deputy directorgeneral Dr Tanarak Plipat stated that the situation of measles and rubella control in Thailand was promising, as the vaccination coverage rate in most part of the country was at 95 per cent and beyond, with the exception of Pattani, Yala and Narathiwat.
“All Thai citizens can get measles and rubella vaccine free of charge,” Tanarak said. “But we have to admit that the vaccination coverage in the Far South is still lower than average, which is because the vaccination campaign in that region faces difficulties from ongoing Southern insurgency.”
He said the anti-vaccination idea was not prevalent in Thailand, but the Public Health Ministry had not ignored the problem and actively promotes the message that people should receive a full course of vaccinations.
There were 2,231 recorded cases of measles in Thailand since the beginning of this year. The infection rate was 3.4 cases per 100,000 population and there had been no death from measles this year.