Transitioning Lessons Learned and Assets of the Global Polio Eradication Initiative to Global and Regional Measles and Rubella Elimination

Abstract

The Global Polio Eradication Initiative has built an extensive infrastructure with capabilities and resources that should be transitioned to measles and rubella elimination efforts. Measles continues to be a major cause of child mortality globally, and rubella continues to be the leading infectious cause of birth defects. Measles and rubella eradication is feasible and cost saving. The obvious similarities in strategies between polio elimination and measles and rubella elimination include the use of an extensive surveillance and laboratory network, outbreak preparedness and response, extensive communications and social mobilization networks, and the need for periodic supplementary immunization activities. Polio staff and resources are already connected with those of measles and rubella, and transitioning existing capabilities to measles and rubella elimination efforts allows for optimized use of resources and the best opportunity to incorporate important lessons learned from polio eradication, and polio resources are concentrated in the countries with the highest burden of measles and rubella. Measles and rubella elimination strategies rely heavily on achieving and maintaining high vaccination coverage through the routine immunization activity infrastructure, thus creating synergies with immunization systems approaches, in what is termed a "diagonal approach."

Keywords: Measles; polio legacy; polio transition; poliomyelitis; rubella; vaccine-preventable diseases.

Figure 1.

Annual reported measles cases and estimated coverage with the first dose of measles-containing vaccine (MCV1) and MCV2, 2000–2015. Coverage data were estimated by the World Health Organization (WHO) and the United Nations Children’s Fund (unpublished data, WHO Joint Reporting Form, 18 July 2016). These data elements to create this figure are available at the WHO IVB data site: http://www.who.int/immunization/monitoring_surveillance/data/en/. Acccessed 19 April 2017.

Figure 2.

Global estimated number of measles deaths in the presence and absence of vaccination, 2000–2015. Compared with no measles vaccination, measles vaccination prevented an estimated cumulative total of 20.3 million deaths during 2000–2015, represented by the shaded area between the solid trend lines. Adapted with permission from the article by Patel et al [4].