Measles mortality reduction--West Africa, 1996-2002

The World Health Organization (WHO) estimates that, during 2000, measles accounted for approximately 777,000 deaths worldwide, of which 452,000 (58%) occurred in Africa. In response, in 2000, WHO's African Regional Office (AFRO) adopted a plan to reduce measles mortality >50% by 2005. The plan recommended 1) increasing measles vaccination by strengthening routine health services; 2) providing a second opportunity for measles vaccination for all children, primarily through wide--age-range supplemental immunization activities (SIAs); 3) enhancing measles surveillance; and 4) improving management of measles cases. The initial wide--age-range SIA targets all children aged 9 months-14 years, regardless of history of measles disease or vaccination. Follow-up SIAs are needed 3-5 years after the initial SIA to provide a second opportunity for vaccination to children born since the previous SIA (i.e., those aged 9 months-4 years). During the 1990s, the countries of the Americas and seven countries in southern Africa used this strategy to reduce the number of measles deaths to near zero. This report describes the recent implementation of this strategy in three West African countries, where reported measles cases declined 83%-97% during the first year after SIAs. Successful implementation of this strategy by other African countries should result in achieving the goal of >50% reduction in measles mortality by 2005.