Measles malaise

According to WHO data, measles cases and deaths worldwide increased by 18 per cent and 43 per cent, respectively, in 2022 as compared to the previous year – taking the estimated number of measles cases to nine million and deaths to 136,000, mostly among children. The surge in deaths and cases comes on the heels of years of decline in measles vaccination coverage, leading to 37 countries experiencing large or disruptive measles outbreaks in 2022, a sharp increase from 22 countries in 2021. According to a joint-report by the WHO and the US Centre for Disease Control and Prevention, first-dose measles-containing vaccine (MCV) coverage rose from 72 per cent to 86 per cent worldwide between 2000 and 2019 but declined to 81 per cent in 2021 during the Covid-19 pandemic. Although first-dose MCV coverage rebounded to 83 per cent in 2022, 33 million children still missed a measles vaccine dose. Of the 22 million who missed their first dose in 2022, over half belong to just 10 countries, including sadly Pakistan. However, reported measles cases in Pakistan have noticeably declined from 10399 in 2021 to 8378 in 2022, as per the WHO.

One should not underestimate the significance of reported measles cases actually going down in 2022, given the disruption to routine immunization services caused by last year’s catastrophic floods. In the aftermath of the disaster, the Expanded Programme on Immunization carried out a measles-rubella vaccination campaign focusing on the displaced, targeting 1.8 million children aged from six to 59 months in several districts. Given the decline in measles, one could say that the campaign was quite successful and a sign that our vaccination networks, while clearly in need of improvement, are quite resilient.

That being said, our measles case count is still among the highest in the world and improving delivery and coverage of vaccines is not a panacea. As long as the risk factors that lead to the spread of communicable diseases remain high, we will be vulnerable to outbreaks of measles, HIV, polio, and much else. According to the WHO, these risk factors include overcrowding, unclean drinking water, poor sanitation and socio-economic conditions, which describes life in much of Pakistan to a tee. Alongside better vaccination coverage, we also need better waste management, more education, poverty reduction, and wider access to sanitation and safe drinking water. In order to build a healthier and safer country for future generations we have to become a country where cities and towns are not prone to becoming incubators of deadly diseases.