Measles deaths are falling, but not far enough

The number of deaths from measles worldwide fell by 74% in the decade between 2000 and 2010, according to the latest estimates — from 535 300 (95% confidence interval (CI) 347 200 - 976 400) to 139 300 (71 200 - 447 800). Measles vaccination alone saved an estimated 9.6 million lives during the same period.

Progress looks good, but the target set by the World Health Assembly to reduce measles deaths by 90% between 2000 and 2010 was not achieved. India in particular seems to be lagging behind its neighbours and the rest of the developing world. In a new modelling study, deaths from measles fell by just 26% in India, increasing the country’s share of deaths from 16% to 47%. The authors blame delays in mass vaccination programmes and slow expansion of routine vaccination. Most of the remaining deaths occurred in Africa. Europe accounted for less than 1% of measles deaths during the study period.

Measles is one of the most infectious diseases for which we have a vaccine, says a linked comment (doi:10.1016/S0140-6736(12)60638-2). Eradication is still possible if countries can sustain and strengthen their vaccination programmes. The new model, unlike previous efforts, factored in the effect of herd immunity and counted real cases tracked by real surveillance programmes where available. The resulting figures remain best guesses, however. Accurate registration of deaths and adequate surveillance are still the exception, not the rule. Ever more sophisticated guessing is no substitute for real data when the ultimate prize is to drive deaths down to zero.

Simons E, et al. Lancet 24 April 2012 (early online publication). [doi:10.1016/S0140-6736(12)60522-4]