progress in measles control in the african region annual measles partnership meeting feb 2007...

Progress in Measles Control in the African Region

Annual Measles Partnership meeting

Feb 2007Washington DC

2Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Outline

• Regional goals

• Routine immunization

• Second opportunity for measles vaccination

• Disease surveillance

• Conclusions/ challenges

• Priorities for 2007

3Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Estimated Reduction in Measles Mortality in AFR, 1999-2005

0

100,000

200,000

300,000

400,000

500,000

1999 2000 2001 2002 2003 2004 2005

75%reduction

2005 Goal

Source: WHO/IVB measles deaths estimates

4Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Regional goal for measles control

• Reduction of measles deaths by 90% by 2009 as compared to estimates for 2000

5Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

ND

Reported measles coverage. AFR. 2005 – Nov 2006

2005

50 - 79%

EMRO<50%

>=80%

ND: No data

Jan – November 2006

ND

6Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Reinforcing Routine EPI

• Measles Partnership support for routine EPI amounting to 10% of operational costs coming through the WHO

• Total USD 2,711,429 between 2004 - 2006

7Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

A total of 297.4 million children reached.

Measles SIAs. AFR. 2001- 2006

8Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa0

10

20

30

40

50

60

70

80

90

2001 2002 2003 2004 2005 2006

Targ

et

pers

on

s r

each

ed

in

mil

lio

ns follow-up SIAs

catch-up SIAs

Target persons reached in measles SIAs. AFR. 2001 - 2006

9Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Measles catch-up SIAs. Nigeria. 2006

< 85%

85 – 94%

95 – 100%

10Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Financial support through the MP for measles control in AFR. 2001 -2006

11Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

UNICEF21.0%

LGAs2.9%

States1.8%

Federal Government of

Nigeria26.5%

GAVI11.7%

WHO35.7%

European Union0.2%

Financial contribution to the catch-up SIAs in Southern Nigeria. 2006

• Government of Nigeria: 31% costs of measles SIAs

12Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Integration of multiple interventions during measles SIAs. AFR. 2006

All 17 countries integrated at least one intervention:

• Vitamin A: 12 countries

• Anti-helminthes: 7 countries

• ITNs:7 countries (mostly sub-national)

• OPV: 5 countries

• TT for WCBA: 1 country

13Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

The AFR measles surveillance and lab network. Feb 2007

14Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Measles surveillance performance indicators in AFR. 2002 - 2006

0%10%20%30%40%50%

60%70%80%90%

100%

Districts Reporting Blood SpecimensCollected

Lab ConfirmedMeasles

2002

2003

2004

2005

2006

15Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Countries planning Measles SIAs in 2007

Target: 22.5 million (+ 9 million SoA) children in 16 countries

16Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Inter-campaign interval for 2007Country Average nat’l routine

measles coverage

(‘03 –‘05)

Burkina Faso 79Congo 57Gabon 35Gambia 88Lesotho 60Mali 89Madagascar 76Mauritania 65Niger 74Togo 71Zambia 79

17Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Inter-campaign interval for 2007Country Average nat’l routine

measles coverage

(‘03 –‘05)

Recommended SIAs interval in yrs (AFR TAG)

SIAs interval in months acc.

to PoA

Burkina Faso 79 3 yrs 35Congo 57 2 yrs 33Gabon 35 2 yrs 37Gambia 88 4 yrs 47Lesotho 60 2 yrs 53Mali 89 4 yrs 36Madagascar 76 3 yrs 38Mauritania 65 3 yrs 38Niger 74 3 yrs 28Togo 71 3 yrs 36Zambia 79 3 yrs 48

18Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Integrated interventions

planned during measles SIAs.

2007

19Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Challenges

• Routine measles vaccine coverage is improving but

not yet adequate even in the “best performing”

countries:

– Sub-national gaps leading to outbreaks

• SIAs integrating multiple child survival interventions

– Risk of decreased funding availability (unpredictable in-

country funding, increasing operational costs)

– Need for better coordination

• Sub-optimal administrative coverage during follow-

up SIAs

20Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Priorities for measles control in AFR. 2007

• Continue efforts to improve routine EPI coverage:

– RED approach

• Continue advocating for more local resource

mobilization for SIAs

• Capitalize on the opportunity for integration to ensure synergy – planning, coordination, funding…

21Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa

Thank you