Halting a childhood disease
by Julie Irby
Over 200 million children will be vaccinated
against measles by 2005 through the Measles Initiative.
Each year measles kills 1 million children,
nearly half a million of those in Africa. An international
partnership is working to combat this medical emergency.
Measles is the leading cause of death among children in Africa
- more than HIV, more than tuberculosis and more than malaria.
The tragedy is that it is a preventable disease. But in places
where health conditions are extremely poor, living conditions
are more than difficult, and access to health care is minimal,
measles can kill.
"We are not so strong that we can treat measles. We
do not have appropriate medicine always and poor people can't
pay for it. Two to three children die from it every day in
the hospital," said Dr. Eriamu, a doctor at the Soroti
Regional Hospital in Uganda. Because it is so contagious and
so common, measles is the only disease that needs its own
Measles can be transmitted by air. Children can contract
it in crowded places like a market or at school just by coming
into brief contact with someone who has it. They usually do
not die directly of measles. It is similar to HIV in that
it weakens the immune system leaving the child vulnerable
to the myriad of diseases festering in poor living conditions.
The direct damage caused by measles can be high fever, peeling
of the skin and encephalitis leading to brain damage. But
the complications due to measles are even more severe and
can include blindness, severe diarrhoea, malnutrition and
A global coalition
The Measles Initiative is a long-term commitment to reduce
the number of deaths in Africa from the disease. The initiative
will vaccinate 200 million children through both mass and
follow-up campaigns in up to 36 sub-Saharan African countries.
By 2005, it is estimated that 1.2 million deaths will have
been prevented, bringing measles deaths in Africa to near
zero. The partners are also exploring potential support for
countries outside Africa that have many measles deaths.
"The mission of the Red Cross is to save lives. Leading
our global partners in the fight against measles gives us
an opportunity to do that on a big scale," said Gerry
Jones, American Red Cross (ARC) vice president of international
In the battle to reduce mortality from measles, partnership
is crucial since each player brings a different strength and
talent to bear. The core partners of the initiative are the
American Red Cross, the United Nations (UN) Foundation and
the Centers for Disease Control and Prevention (CDC), in collaboration
with the UN Children's Fund (UNICEF), the World Health Organization
(WHO) and the International Federation of Red Cross and Red
Crescent Societies. Over 100 other public and private organizations
support the initiative. The main in-country actors, actually
conducting the immunization campaigns, are the local ministries
of health and Red Cross and Red Crescent societies.
UNICEF believes that every child has the right to be immunized
and protected from measles and other vaccine-preventable diseases.
"Every minute, one child dies from measles in Africa.
This is unacceptable," said Carol Bellamy, executive
director of UNICEF. "Measles vaccination campaigns will
reverse this trend and give children a good start in life."
In February 2001, the ARC, Federation, CDC, UNICEF, UN Foundation
and WHO met to discuss the growing problem of measles in Africa.
"We looked at problems that afflict the world and we
found that measles was a big one. What is so tragic about
the deaths is that they are preventable," said Gerry
In order to accomplish the goal of saving 1.2 million child
lives in Africa over five years, mass measles vaccination
campaigns will be conducted in countries throughout Africa.
The campaigns are a coordinated effort of health workers,
volunteers and communities to ensure that within a short period
of time vaccination teams reach every child. They are carried
out over several days for children under 15 years of age.
Follow-up campaigns occur three to four years after the initial
mass campaigns for children under five years of age who did
not receive the vaccine during the first mass campaign.
- Measles is the leading vaccine-preventable childhood killer
in the world
- Each year, 30 to 40 million children suffer from measles
and 1 million die from the disease
- In Africa alone, 200 million children are at risk from
- More than 12 million cases occur in Africa each year
- Every year, more than half the deaths caused by measles
occur in Africa (i.e. about 450,000). This means that, in
- 1,200 children die every day of measles
- 51 children die every hour of measles
- one child dies every minute of measles
- Visible signs of measles include fever, rash, running
nose, cough, red eyes, red lips, peeling of the skin, and
difficulty in breathing
- Measles can also cause blindness and brain damage, and
make a child susceptible to secondary infections such as
pneumonia and diarrhoea
- Measles vaccination is the most cost-effective public
health intervention available for preventing deaths
- It costs less than US$1 to vaccinate a child against measles
- During the first year of the initiative (July 2001-June
2002), mass measles campaigns are being carried out in eight
African countries, vaccinating more than 20 million children
and preventing more than 140,000 death
A saving for all
WHO considers the administration of measles vaccine one of
the most cost-effective public health interventions available,
at a cost of less than US$1 per child.
Sarah Salamula, whose five-year-old had been in a hospital
in Pallisa district, Uganda, for four days battling complications
due to measles, said that he is getting better. "We are
poor and all our money goes to treating my children."
She plans to take her children to be vaccinated hoping that
there will be no more unnecessary expenditures and that "it
will keep my children healthy and happy and their bodies will
Mass measles campaigns were carried out in eight African
countries in 2001, the first year of the initiative. More
than 20 million children were vaccinated, preventing more
than 140,000 deaths. Countries involved included: Benin, Burkina
Faso, Cameroon, Ghana, Mali, Tanzania, Togo and Uganda. The
National Societies were responsible for reaching over 5 million
of these 30 million children, in many cases going from house
to house to explain that measles kills, that it can be prevented
through immunization and that vaccinations are free. The partners
anticipate that 12 countries will be targeted for the second
year, vaccinating 53 million children and preventing over
One of the first babies brought for immunization during
the November 2001 campaign in Uganda, came with his mother
who had suffered from polio. She dropped her baby off to the
vaccinators so she could get back to tending her garden, their
main source of food. "I don't want my baby to have problems
like me," she said. Her husband left when the baby was
born two and a half years ago. "I could not have managed
to get my child vaccinated if the vaccine was not free. I
want my child to be vaccinated so he won't be like me."
Julie Irby is an associate in the international communications
department of the American Red Cross.
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