In the 1990s, a coalition of leading health organisations declared that it was feasible, technically, to eradicate measles worldwide by 2010.
And although there have been varying degrees of success, including widespread vaccine campaigns, there has been a resurgence of the disease from 2008.
Stealthy disease
“It’s a stealthy virus,” Dr Diane Griffin, during her delivery of the Frank Black Memorial at the Yale School of Public Health in the United States.
A vaccine has been available since 1971 and it is 95% effective in small children. But over time those without immunity, as well as those who have not received the vaccine at all, creates a large number of people who are susceptible.
In 2014, there were approximately 115,000 measles-related deaths worldwide, according to the World Health Organization.
Stats in SA
According to the National Institute of Communicable Disease, South Africa has not been immune. This time last year it reported: “There has been an increase in the number of measles cases in the country since September 2014. As at 31st January 2015, 62 cases were reported in 2014 and 4 in 2015.”
“Of concern, there have been 32 cases from Northern Cape, 16 from Gauteng and four from Western Cape in the last 4 months. For comparison, there were only six cases for South Africa in 2013. This increase is concerning, as in 2009-2011 South Africa had a large measles outbreak with 18,000 cases, and we don’t want to see this again.”
What went wrong with the push for eradication?
The obstacles to eradication differ in developing and developed countries, Griffin said.
In the developing world, decreases in funding have undermined many countries’ strategy of mass immunisation of all children under the age of 15. While such campaigns drove progress against the disease until 2008, the blanket approach is expensive to sustain with a syringe-administered vaccine that requires trained personnel.
In the developed world, meanwhile, the success of vaccination left a generation of parents unfamiliar with the disease and its dangers. In addition, many parents remain concerned about administering too many shots to their children and over perceived safety issues, she said.
What’s the solution?
Griffin expressed optimism that new approaches—such as delivery of the vaccine through aerosols or dry powders that don’t require refrigeration or medical personnel— will overcome many of these obstacles in a way that is cost effective.