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Measles Control in SEAR Current Progress and Way Forward

Measles Control in SEAR Current Progress and Way Forward. American Red Cross Measles Meeting Washington DC 13 th Sept 2011. Presentation Structure. Regional goals Regional progress Opportunities for measles elimination Challenges.

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Measles Control in SEAR Current Progress and Way Forward

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  1. Measles Control in SEARCurrent Progress and Way Forward American Red Cross Measles Meeting Washington DC 13th Sept 2011

  2. Presentation Structure • Regional goals • Regional progress • Opportunities for measles elimination • Challenges

  3. Current regional goal and regional consultative processes for measles elimination Regional consultation on measles, SEARO, August 2009 Consensus on technical and biological feasibility of measles elimination Programmatic feasibility for elimination varied between countries 62nd Regional Committeein 2009 In 2009, the Regional Committee passed a resolution urging Member States to move towards eliminating measles 63rd Regional Committeein Sept 2010 Interim goals approved by the 63rd World Health Assembly (May 2010) should be adopted By 2015 -MCV1 coverage >90% nationally and >80% in all districts -Incidence <5/million -Reduce mortality by 95% compared to 2000

  4. Recent Development • High-Level Ministerial Meeting (HLMM) of SEAR countries on Increasing and Sustaining Immunization Coverage in South East Asia convened in New Delhi, India: 2 August 2011. • 2012 to be declared the Year of Intensification of Routine Immunization in countries of South-East Asia Region • Endorsed by the 64th Session of the WHO Regional Committee

  5. Status of measles control activities in SEAR 2011 • Implementing elimination strategies (9) • Bangladesh, Bhutan, DPR Korea, Indonesia, Maldives, Myanmar, Nepal, Sri Lanka and Thailand • Advanced stage of mortality reduction (1) • Timor-Leste • Accelerated implementation of mortality reduction strategies (1) • India

  6. Estimated measles mortality (2000-08), MCV1 coverage and SIA achievements SEAR, 2000 to 2010 2000-2010: 153 million children immunized through MEASLES SIA 46% Reduction

  7. Coverage (%) of 1st dose of Measles Containing Vaccine in infants: 2005-2010 Source: WHO/UNICEF 2010 estimates

  8. Second dose of measles (MCV2) by strategy ( as on 2010) 2000-2010: 153 million children immunized through MEASLES SIA

  9. 2nd opportunity/2nd dose of Measles vaccine: State specific Delivery strategies MCV1 coverage national average : 69% 2010-2012: SIA target 134 million children (9 mo-<10 years) SIA: 14 states MCV1 <80%: RI: 21 states (MCV1 > 80%) MCV1: Coverage of Measles containing vaccine per DLHS-3; CES-06 for Nagaland

  10. Summary of measles surveillance SEAR 2010* Case based in 11 states 11 states *Based on monthly data sent

  11. Measles Surveillance Indicators SEAR 2009 and 2010

  12. India: Scale-up of laboratory enhanced measles outbreak surveillance 2006 2007 2009 2010 2011

  13. Challenges for the Region … 1/3 Target population 5 countries (IND, INO, MMR, NEP, TLS) with nearly 83% of the population will need to increase MCV1 coverage by 12-25% to reach 95% level By 2020, one billion children to be vaccinated above the current immunization trends through SIA and MCV2 Building strong political commitment and full country ownership when there are competing health priorities.

  14. Challenges for the region … 2/3 Adequate resources (equipment, staff, training and supervision) commitment to ensure Safe injection practices and waste disposal. System for monitoring and responding to Adverse Events Following Immunization (AEFI) Establishing a high quality surveillance system that meets surveillance performance indicators

  15. Challenges: Funding support for SIA and surveillance in 2011 -12 (3/3) Funding for SIAs (Myanmar and Nepal) WHO regional office for surveillance and technical support Technical support for India. Surveillance Costs (Bangladesh, India, Indonesia, Myanmar and Nepal) Support for Indonesia towards operational costs for campaigns and technical support.

  16. Enabling factors … 1/2 Regional consultation on measles, 2009: Technical experts agreed that Eight countries (Bangladesh, Bhutan, Indonesia, Nepal, Thailand, Myanmar, Maldives and Sri Lanka) could achieve measles elimination by 2015 For India and Timor-Leste elimination would be feasible by 2020 Regional consultation on measles, 2011: Technical experts agreed that immunization is a highly cost-effective public health intervention to improving child survival and presents immense opportunities to make sustainable gains in health, bringing the member states of the Region closer to achieving the MDG-4 for child mortality reduction Political commitment present. National Governments funding measles in RI and catch-up campaign Major contributions from Govts. Of Bangladesh, Bhutan, DPR Korea, Maldives, Myanmar and Sri Lanka India: All costs for MCV2 and SIA borne by National Govt.

  17. Enabling factors … 2/2 Vaccine supply and security At least two countries in the Region have measles vaccine production capacities Can be scaled up to match additional demand Excellent community acceptance and safety profile of catch-up campaigns Support from Polio eradication infrastructure in five priority countries Bangladesh, India, Indonesia, Myanmar and Nepal Laboratory support to measles surveillance adequate and can be scaled up Built on Polio laboratories infrastructure plus Inclusion of new labs for laboratory supported surveillance for measles

  18. SIA plan 2011-12 * Subject to government confirmation

  19. Summary • Most of the member countries have successfully implemented strategies for measles mortality reduction and moving towards elimination • Year 2012 declared the Year of Intensification of Routine Immunization in countries of SEAR • India has planned to provide second dose ( campaign and RI) • Collaboration of all stakeholder is necessary to overcome challenges • Immunizing large numbers • Reach and maintain surveillance standards

  20. Thank you

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