The challenge of achieving measles elimination in the eastern Mediterranean region by 2010

In 1997, the Eastern Mediterranean Region (EMR) of the World Health Organization adopted a resolution to eliminate measles by 2010. Of the 23 EMR member countries, 18 are polio-free and are building on this success to eliminate measles. The 5 countries where polio remains endemic are prioritizing polio eradication and working to improve measles control. Measles incidence has been reduced from 193/100,000 in 1981 to 6.8/100,000 in 2001. Supplemental vaccination campaigns for measles have been conducted since 1994 in 14 of the 18 polio-free countries. More than 50 million children have been immunized in these supplemental activities. However, in Afghanistan, Sudan, Somalia, Djibouti, and Pakistan, where 34% of the EMR population live, routine vaccination coverage for measles remains below 60% and measles deaths are estimated at 81,000 annually among children <5 years old. Significant resources must be allocated to these last 5 countries to achieve regional measles elimination by 2010.