Critical Response

How USAID fights measles across the world

A measles immunization campaign in Madagascar. / Amy Fowler, USAID

Measles, a disease that was declared eliminated in the United States in 2000, has returned with a vengeance with outbreaks across the country and around the world.

According to the World Health Organization (WHO), 112,163 cases of measles have been confirmed in 2019 alone, with 98 countries reporting an uptick in measles cases in 2018.

USAID works to strengthen routine immunization systems in 25 countries to ensure that vaccinations are administered to those who need them most and immunity is built against vaccine preventable diseases like measles. In the face of outbreaks, USAID also helps countries respond with vaccination campaigns, education on the importance of routine immunization, and outreach.

DEMOCRATIC REPUBLIC OF CONGO

Bati Bobubela, a USAID-supported community health worker, shows women how to prevent their children from getting ill at the community health site in Yatutu, near Isangi. The nearest health center is an eight-hour journey and before this site was established, many children were dying from easily treatable illnesses. / Kate Holt, MCSP

The Democratic Republic of Congo (DRC) has suffered from years of conflict and ongoing insecurity, straining an already fragile health system. This year alone, the country has already reported 49,942 cases and 923 deaths from measles.

To combat measles and other vaccine-preventable diseases in the DRC, USAID partners with diverse organizations, from local and international NGOs to WHO and the United Nations Children’s Fund (UNICEF), to strengthen routine immunization and help build stronger, more resilient health systems. Through these partnerships, USAID supports health providers and communities to strengthen community engagement and reduce vaccine refusal among hard-to-reach communities, and to improve data quality and surveillance systems so that resources are targeted where they are most needed.

Mother Basomboli Bolese, forty-four, is pictured above with her youngest baby. She explained, “four of my children died from sickness — malaria and measles. This was a while ago. They weren’t vaccinated. But now my children are getting vaccines.” In Basomboli’s village, two community members run a health site where children can get basic medicines. USAID is providing essential clinical training to health workers. / Kate Holt, MCSP

Routine immunization is a critical and cost-effective first line of defense against health emergencies. Recognizing this, USAID is supporting the DRC’s Ministry of Health, in close coordination with the Centers for Disease Control and Prevention and other partners, to develop the country’s first National Health Security Action Plan to ensure that routine immunization is a key strategy under that plan.

MADAGASCAR

Harenaur Loafara, thirty-six, brought in her two-year-old daughter Cedree for the measles vaccine. Harenaur explained, “we’re here because there have been children in our neighborhood who have contracted measles and we want to be safe and proactive.” / Amy Fowler, USAID

Madagascar’s current measles outbreak is the worst one experienced in decades. From September 2018 to April 2019, it has infected 135,067 people and claimed 1,260 lives. In a nation with a fragile health system, massive outbreaks of highly contagious diseases such as measles wreak havoc.

Since the start of the outbreak, USAID has continued to deliver routine immunizations while also delivering “catch-up” outreach campaigns for unvaccinated children. Our support educates community members about the importance of routine immunization through workshops and radio and television messaging.

Measles immunization campaign at a school in Antsiranana, Madagascar. / Amy Fowler, USAID

On a sunny morning in March at the Centre de Santé Urbaine Tanambao in Antsiranana, USAID-supported hospital staff vaccinated children ages six months to nine years against measles.

That afternoon, USAID-trained community health volunteers assisted with a measles clinic at a local school.

SOUTH SUDAN

World Health Organization officers train vaccinators in Mayom, South Sudan. / WHO

As of April 2019, South Sudan has faced more measles outbreaks than in all of last year and further spread of the disease has been difficult to halt. Years of political strife and difficult humanitarian access have contributed to significant gaps in vaccine coverage, resulting in thousands of unvaccinated children. Rates of routine immunization in South Sudan are estimated to be at 59 percent, whereas the accepted threshold for critical immunity is between 93 and 95 percent.

USAID helped to vaccinate 1.6 million children in South Sudan for measles in 2018 during two national routine immunization campaigns. These included coverage for internally displaced populations who had fled their homes due to conflict. USAID is also working with local emergency response teams to coordinate vaccine campaigns in the most high-need counties. Over 100,000 children have been reached with coverage since the campaigns began, which target children aged six months to five years old, accounting for 90 percent of reported measles cases in outbreak regions.

VENEZUELA

Latin America has made great strides toward eliminating measles, but an unprecedented outbreak in Venezuela has led to a resurgence of the disease in not only Venezuela but also other countries in the region.

Although Venezuela is not currently a target country for the Agency’s immunization efforts, USAID is providing vaccinations and building disease response capacity in communities in Colombia and Peru that are hosting vulnerable Venezuelans.

PROTECTING THE HOMELAND

Investments in global health promote American humanitarian values and help keep the homeland safe. Countries with stronger health care systems have healthier populations and more sophisticated disease surveillance systems to track and prevent pandemics. This helps ensure stability in those countries while helping to keep Americans safe at home.

To reduce the risk of further outbreaks, USAID supports routine immunization, which yields up to a 44-fold return on investment and can prevent an estimated two to three million child deaths per year.

The Agency has supported Gavi, the Vaccine Alliance, for more than 18 years with the shared goal of creating equal access to vaccines for children, wherever they live.

For more than half a century, USAID programs have saved and improved lives around the world, advancing American values and increasing global stability.

About the Author

Catherine Korona is a Communications Analyst with USAID’s Office of Maternal and Child Health and Nutrition.