1. Session 1: New Opportunities and New Direction
Chair: Narendra Arora
Rapporteur: Kaushik Banerjee
Session Lead: Peter Strebel

2. Objectives
To provide brief updates on the programme and laboratory network
To inform participants about the new Gavi measles strategy
To share conclusions and draft recommendations from the midterm review
Time for comment and Q and A

3. Agenda Time Topic Presenter 9:15 1. Global measles and rubella update
Peter Strebel
9:30
2. Global Measles and Rubella Laboratory Network update
Mick Mulders
9:45
3. The new Gavi measles strategy
(Commentary from Gavi)
Devi Aung
(Seth Berkley)
10:00
Discussion
10:30
Coffee break
11:00
4. Findings and recommendations from the Midterm Review
Walter Orenstein
11:40
Commentary
Rebecca Martin
Peter Figueroa
12:00
Plenary Q and A
12:30
Lunch

4. Global Measles and Rubella Programme Update
Accelerating Progress Towards Measles and Rubella Control/Elimination Goals
Geneva, 21 June 2016
Peter Strebel, WHO, IVB/EPI

5. E. Mediterranean, W. Pacific
2015 Status Report
Milestone/Goal
Achieved
Not Achieved
Global control milestones:
Measles mortality reduction >95% vs. 2000
79%
Further 16% reduction
National MCV1 coverage >90%
122 (63%) countries
62 (37%) countries
Reported measles incidence <5 per million
125 (64%) countries
69 (36%) countries
Regional elimination goals:
Elimination of measles in 4 WHO Regions
None
American, European,
E. Mediterranean, W. Pacific
Elimination of rubella in 2 WHO Regions
American Region
European Region

6. Measles

7. Annual reported measles cases and MCV1* and MCV2** coverage, 1980-2015
* MCV1 coverage: coverage with first dose of measles-containing vaccine as estimated by WHO and UNICEF.
**MCV2 estimates is only available from 2000 when global data collection started, however some countries have introduced the vaccine earlier.
Source: WHO/IVB database, 2015
194 WHO Member States.
Updated on 15 July 2015

8. Annual number of measles cases by WHO Region, 1980-2015*

9. World Health Organization
16 November, 2018
WHO/UNICEF Estimates of Vaccination Coverage with the 1st Dose of Measles Containing Vaccine, 2014
37 (20%) countries have <80% coverage with 1st dose of measles containing vaccines
<50% (4 countries or 2%)
50-79% (33 countries or 17%)
80-89% (35 countries or 18%)
90-94% (46 countries or 24%)
>=95% (76 countries or 39%)
Not available
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. © WHO All rights reserved
Not applicable

10. Countries using a routine 2nd dose of measles containing vaccine (MCV2) in their national programme
32 countries have introduced a routine 2nd dose of measles vaccine since 2008
Introduced before 2008 (128 countries or 66%)
Planned introductions in 2016 (2 countries or 2%)
Not Available/ Not Introduced/ No Plans (32 countries or 16%)
Not applicable
Introduced between 2008 and 2015 (32 countries or 16%)
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. ©WHO All rights reserved.
Data source: WHO/IVB Database, as of 14 June 2016
Map production Immunization Vaccines and Biologicals (IVB),
World Health Organization

11. Measles Campaigns in 39 Countries in 2015
180 million children reached
40/66 (61%) attained 95% coverage
18/66 (27%) with coverage survey
4 surveys document >95% coverage
42 of 66 SIAs integrated 1 or more other interventions
Measles (21)
Measles and Rubella (15)
Measles, Mumps and Rubella (3)
OPV – 15
Vitamin A – 15
De-worming – 8
Other interventions – 1
No SIA in 2015
Not Applicable
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. ©WHO All rights reserved.
Updated on 15 April 2016

12. Reported Measles Incidence Rate*, May 2015 to April 2016
*Rate per 1'000'000 population
<1
(92 countries or 47%)
≥1 - <5
(33 countries or 17%)
≥5 - <10
(21 countries or 11%)
≥10 - <50
(25 countries or 13%)
≥50
(13 countries or 7%)
No data reported
to WHO HQ
(10 countries or 5%)
Not applicable
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. ©WHO All rights reserved.
Data source: surveillance DEF file
Data in HQ as of 13 June 2016

13. Vaccination status of reported measles cases,
63% of cases

14. Rubella

15. World Health Organization
16 November 2018
WHO/UNICEF Estimates of Vaccination Coverage with Rubella Containing Vaccine* (RCV), 2014
46%
Source: WHO/UNICEF coverage estimates 2014 revision. July 2015
Immunization Vaccines and Biologicals, (IVB), World Health Organization.
194 WHO Member States. Date of slide: 16 July 2015.
*MCV1 was used as a proxy in the Member States that have introduced Rubella vaccine.

16. 17 countries introduced rubella vaccine during 2012-2015
Countries with rubella vaccine in the national immunization programme, by year of vaccine introduction
17 countries introduced rubella vaccine during
16 countries planning introduction in
Introduced before 2012 (130 countries or 67%)
Planned introductions in (16 countries or 8.2%)
Not Available/ Not Introduced/ No Plans (31 countries or 16%)
Not applicable
Introduced between 2012 and 2015 (17 countries or 8.8%)
The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. ©WHO All rights reserved.
Data source: WHO/IVB Database, as of 14 June 2016
Map production Immunization Vaccines and Biologicals (IVB),
World Health Organization

17. Estimates of the median incidence of CRS per 100,000 live births by country in 2010
Vynnycky E, Adams EJ, Cutts FT, Reef SE, Navar AM, et al. (2016) Using Seroprevalence and Immunisation Coverage Data to Estimate the Global Burden of Congenital Rubella Syndrome, : A Systematic Review. PLoS ONE 11(3): e doi: /journal.pone

18. Regional Elimination

19. Progress Towards Measles & Rubella Elimination, by WHO Region, 2014-5
Regional Verification Commissions Established
Measles Elimination Achieved
Rubella Elimination Achieved
No. of countries
% of countries
Americas1
Yes 34
97% 35
100%
Europe2 22
41% 23
43%
Western Pacific3 6
22% -
Eastern Mediterranean No
South-East Asia
Africa
1. Progress report on Plan of Action for Maintaining Measles, Rubella, and CRS Elimination in the Americas, 12 Sept 2014
2. Third meeting of the European Regional Verification Commission for Measles and Rubella Elimination Nov 2014 3.

20. 2015 Assessment Report of GVAP -- on measles and rubella goals
Conclusion:
The elimination strategies for maternal and neonatal tetanus, and for measles and rubella, and their implementation, are in urgent need of change and adequate resourcing.
Recommendation:
Global, regional and national development partners support countries in securing the required resources and in implementing their measles and rubella elimination or control goals taking into account the results and recommendations of the midterm strategy review to be conducted in 2016.

21. Summary
High level measles control being maintained and over a million measles-related deaths averted each year
Large outbreaks continue and progress has slowed
Rubella elimination verified in the Americas and gradual increase in global rubella vaccination coverage
Over half of the world's children not being vaccinated
Global 2015 measles control milestones will not be achieved on time and regional measles and rubella elimination targets are off-track (except for Americas)
Midterm review to understand why and what can be done

22. Acknowledgements Information provided by: Funding support by:
Country programmes
WHO Regional Offices
Strategic Information Group, WHO/EPI
Minal Patel
Laure Dumolard
Catherine Steulet
Olivier Beauvais
Marta Gacic-Dobo
Funding support by: