WASHINGTON - In modern history, Africa has been the epicenter of pestilence, including malaria, river blindness, and the AIDS pandemic. But aggressive prevention campaigns in Africa over the past seven years have helped the continent shed the measles scourge, whose center has now shifted to South Asia.
Health officials yesterday reported that the number of global deaths from measles has plunged 68 percent since 2000, including an astounding 91 percent reduction in Africa. They estimated that South Asia has recorded 74 percent of all measles deaths.
The battle against measles has unfolded quietly across Africa and other parts of the world compared with more highly-publicized global campaigns against AIDS, malaria, tuberculosis, and polio. But the advances made against measles, officials say, mark one of the most significant public health breakthroughs in recent times, as measured by the number of children's lives saved.
In 2000, World Health Organization officials estimated that 757,000 people - nearly all of them children under age five - died from measles. In 2006, that figure dropped by more than half, to 242,000 deaths. In Africa, the decrease was even more dramatic: from 396,000 measles deaths in 2000 to 36,000 in 2006.
"This major public health achievement is a result of the hard work of African governments to fully implement the measles reduction strategy," Dr. Luis Sambo, WHO's regional director from Africa, told reporters in a conference call from Brazzaville, Republic of Congo.
A highly infectious disease, measles is characterized by red spots on the skin, a high fever, and a runny nose. It can become fatal when complicated by other diseases such as severe pneumonia, diarrhea, and encephalitis.
Before the measles vaccine was introduced in 1963, roughly 500,000 cases were reported in the United States annually. Now, because of high immunization rates, domestic outbreaks are rare. US health officials confirmed 66 cases of measles in 2005, the last statistical year available.
The global eradication strategy has involved efforts to immunize every child between nine months and 15 years with an injectible measles vaccine. The campaign has taken place in 40 countries over the past seven years.
"The vaccine was delivered on foot, by boat, on motorcycles, even by camels," said Bonnie McElveen-Hunter, board chairman of the American Red Cross. The agency is one of the partners in the initiative to fight measles.
McElveen-Hunter, who had recently traveled to Madagascar to witness the measles campaign, noted there is a "great deal of pride in these really remote communities" to have all children vaccinated. Globally, the initiative helped raise the number of children who received measles immunizations to 80 percent, up from 72 percent in 2000.
A coordinated effort from outside donors and health specialists has raised and spent a combined $450 million in the last seven years. In addition to the Red Cross and WHO, the other partners for the measles initiative are UNICEF, the UN Foundation, and the US Centers for Disease Control and Prevention.
The outside funding included $197 million raised by the GAVI Alliance, a relatively new player in global health that has received strong support from the Bill & Melinda Gates Foundation. GAVI, which in the last several years has spent $3.5 billion for a wide range of immunization efforts in 76 poor countries, announced yesterday a plan to give $370 million to countries immunizing against Haemophilus influenzae type b, which causes severe infections including pneumonia and meningitis.
But to reach its goal of reducing measles deaths to 75,000 a year by 2010, officials said they must intensify their efforts in South Asia, particularly India and Pakistan. An estimated 178,000 people died of measles in South Asia last year, a 26 percent decline since 2000, officials said.
CDC Director Dr. Julie Gerberding said major challenges remain, including poor access to children in some remote, unsecure areas - she mentioned Afghanistan, Pakistan, the Democratic Republic of Congo, and Somalia - and competing priorities, such as the effort in India to eradicate polio.
"We have to acknowledge that 242,000 children dying of measles is still too many," she said. "These are unacceptable figures."
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