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Global crusade to combat measles
An ambitious international immunization program aims to halve the number of deaths attributable to measles by 2005. There are now more than 30 million cases of measles a year and they result in nearly 900 000 deaths, even though the vaccine costs just US$0.26 per person and has been available for more than 30 years (see page 1614).
Coordinated by the World Health Organization and UNICEF, the Global Measles Strategic Plan will spend US$984 million to combat the problem. "A lot had been done in the most affected countries, but on an uncoordinated and intermittent basis," says WHO spokesperson Melinda Henry. "There is renewed interest in immunization as a cost-effective intervention thanks to the Global Alliance for Vaccines and Immunization [GAVI], coupled with a concern for the high death toll."
Formed in 1999, GAVI is an alliance of public- and private-sector partners that includes the Bill and Melinda Gates Children's Vaccine Program; it is chaired by WHO's director general.
Under the global strategy, the 2 UN agencies will collaborate with countries involved to assess current measles immunization programs, identify reasons for low routine coverage and develop a 3- to 5-year plan to reduce mortality and implement an immunization strategy. The organizations will help countries vaccinate all children once and provide a second opportunity to encourage as many people as possible to have their children immunized. The aim is coverage of more than 90% of children. In 1999, measles coverage below 50% was reported by 14 countries, mostly in Africa.
Dr. Suomi Sakai, UNICEF's chief of immunization activities, says coverage levels above 90% are needed to stop measles-related deaths. Of all health interventions, says WHO, measles immunization carries the highest health return for the money spent. Barbara Sibbald, CMAJ