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Progress in Measles Control in the African Region
Annual Measles Partnership meeting
Feb 2007Washington DC
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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
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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
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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
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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
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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
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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
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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
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9Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
Measles catch-up SIAs. Nigeria. 2006
< 85%
85 – 94%
95 – 100%
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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
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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
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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
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13Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
The AFR measles surveillance and lab network. Feb 2007
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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
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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
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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
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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
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18Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
Integrated interventions
planned during measles SIAs.
2007
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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
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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…
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21Bureau Régional de l’OMS pour l’Afrique / WHO Regional Office for Africa
Thank you