Saving Lives Through Childhood Vaccines: Q&A with Andrea Gay of the United Nations Foundation

Can we eliminate measles? Andrea Gay, Executive Director of Children’s Health at the United Nations Foundation, certainly believes it is possible. An expert on under 5-child survival, she says that closing the gap in coverage and investing in expanded access are key to the elimination of this deadly disease.

Find out more in the following Q&A, as well as in our newly released study on Childhood Vaccination, the latest component of our child health toolkit for donors. In this case study, we highlight the work of the Measles and Rubella Initiative, a global partnership that has vaccinated over 1.1 billion children since 2000 and contributed to an 85% decline in measles related mortality. The cost to fully protect a child against measles is just $2. We estimated that the cost per child life saved with measles vaccination is under $200.

We have seen that childhood vaccines have been one of public health’s greatest success stories. If the measles vaccine has been around since the 1960s, why are there still so many children dying of measles?

The major reason is that children are still not getting vaccinated. In too many countries with weak health systems, children lack access to life saving vaccines and do not receive the two doses of measles vaccine that convey life-long immunity against measles. Measles is one of the most contagious diseases ever known and is an important cause of death and disability among young children. In 2011, measles claimed 430 lives every day. Unless there is very high degree of immunity (over 95% of the population vaccinated with two doses), the measles virus will find a susceptible host and spread quickly. In some countries with high vaccination rates where measles may be largely unknown, people may not be concerned about measles and become less motivated to have children vaccinated.

What distinguishes the approach used by the Measles and Rubella Initiative?

The approach developed in the Americas (where measles has been eliminated) and adopted throughout the world enables health workers to reach and vaccinate all children in a target age range. The approach is to improve coverage with the first dose of measles vaccine at 9 months, ensure children receive a second dose of measles vaccine at 18-24 months and use periodic countrywide campaigns to vaccinate all children to ensure no child is missed. High quality disease surveillance is a critical component to provide data which measures the results.

What are the Measles & Rubella Initiative’s strategic steps for the next five years? How can philanthropic investment help?

Support to countries to improve the quality of measles campaigns and quality of surveillance to measure outcomes are critical steps.  By mid-September of this year, we expect 194 countries in the world will have measles elimination targets by or before 2020. Introducing rubella vaccine in combination with measles vaccines (MR) in the remaining countries without rubella vaccine will enable countries to prevent Congenital Rubella Syndrome (CRS) in the over 100,000 babies born with this disease every year. Philanthropic investment can help with financing and advocacy in countries to eradicate measles and control CRS by 2020.

How feasible is global eradication of the measles virus? What will it take?

Global progress against measles in just a decade has been stunning. As more countries immunize more children, measles deaths have been reduced by 71% from 548,000 in 2000 to 158,000 in 2011.  No single other health intervention has returned these mortality reduction results in such a short space of time. Over one in five child deaths averted since 1990 are due to measles vaccination.  In the Decade of Vaccines document, estimates of future deaths averted by vaccines places measles vaccine greater than the sum of the high estimates of all other vaccines combined. A Global Technical Consultation on the Feasibility of Measles Eradication was held in July 2010 at the Pan American Health Organization. Their conclusions were that global measles eradication is feasible and cost effective and therefore, that measles can and should be eradicated. They also noted that eradication is feasible by 2020.  Measles eradication is programmatically, operationally, and biologically feasible and adequate multi-year financing is crucial. We have a strategy that works and the most important activity now is to ensure countries have the resources to implement this strategy as rapidly as possible.

Childhood Vaccination: A life saving investment

Measles vaccination is a low-cost high impact tool for reducing child mortality. In improving supply chains, mobilizing communities, and monitoring success through case-based surveillance, donors can work towards elimination of this deadly disease. Visit our Child Health Guidance to learn more and take action.