New focus on preventing measles

The East African countries of Kenya and Uganda have begun preparations to conduct five-year nationwide measles immunisation drives as part of a global initiative launched last week to save the lives of 1.2 million children in Africa and reduce child mortality over the next five years. Measles, a disease that attacks children under five years of age, is the single leading cause of death among children in Africa - causing greater mortality than HIV, than tuberculosis and malaria. The disease kills more children in Africa because the health of many children is already compromised by poor living conditions, poor immune systems, malnutrition and poor access to medical care, according to health experts. Dr Eva Kabwongera, child survival and nutrition project officer for the United Nations Children's Fund (UNICEF) in Uganda, told IRIN on Monday that the country had completed the first phase of its measles national immunisation programme, started in 1999. It was currently developing a five-year plan, which was expected to be ready by the end of the first quarter of 2002, she added. The first phase, targeting all children in Uganda under the age of five years, was successful only "to a certain extent" because it excluded children of a higher age group, who are also vulnerable to measles, according to Kabwongera. Under the current plan, it is intended to increase the age group of children targeted for immunisation, from those under five years to those between five and 14 to 15 years, she said. "Our aim at the time [of the first phase] was to reduce mortality and morbidity but its benefits are going to be short-lived, because we only targeted the lower age group. Immediately after the campaigns, almost no cases of measles were reported," Kabwongera added. In Kenya, a US $15 million nationwide anti-measles campaign is planned for 17-22 June 2002, according to government health officials. Josephine Lesiamon, who heads the measles programme at the Kenya Expanded Immunisation Programme (KEIP), the body charged with coordinating immunisation programmes within the Ministry of Health, told IRIN on Monday that the campaign would target some 14 million children in Kenya aged between nine months and 15 years. "We are trying to identify the kind of resources we will require. Already, we have a few organisations which are undertaking activities pertaining to their capabilities. We also have a group involved with social mobilisation," she said. The wide age group targeted by the campaign is aimed at capturing the population of children who may have escaped vaccination when immunisation rates in the country were low, according to Lesiamon. Abbas Gullet, head of the Kenya Red Cross Society, which has a national network of volunteers, told IRIN that his organisation would contribute volunteers for door-to-door campaigning to augment the government's measles awareness effort throughout the country. "The Red Cross has been enlisted because it is a civil society with a network of branches everywhere," he said. "Our volunteers will be doing the door to door campaigns, but our role is to complement and supplement the efforts of the government," Gullet added. The global Measles Initiative, supported by five leading global public health organisations, is aimed at controlling measles deaths in Africa by supporting immunisation services in the continent. In a joint statement issued on 6 February, the American Red Cross, United Nations Foundation, the US-based Center for Disease Control and Prevention (CDCP), UNICEF and the World Health Organisation (WHO) stated that the Measles Initiative was a "long term commitment" to control measles deaths. "Because Africa has the highest rate of mortality among children under five due to measles, the focus of mass measles campaigns started there," the statement added. The five-year Measles Initiative is intended to target up to 200 million children through both mass and follow-up campaigns in up to 36 sub-Saharan African countries. Although the campaign has just been officially announced, it actually got underway last year with the inoculation of 20 million children in Uganda, Tanzania, Mali, Burkina Faso, Togo, Benin, and Cameroon, the Voice of America reported on Thursday 7 February. Africa has an estimated 12 million cases and 450,000 measles deaths annually. Half of the children born in Africa will get measles this year and four out of every 100 individuals who contracts the disease will die from it, according to the Measles Initiative statement. "Measles is one more assault on kids in Africa, but it is easily prevented," it quoted Mark Grabowsky, technical adviser on measles for American Red Cross, as saying. "We want to prevent the disease rather than treat it. Children who get measles in Africa have a good chance of dying from it," said Dr Issa Makumbi, Director of Uganda National Expanded Programme of Immunisation (UNEPI). "It is very overwhelming to see so many sick kids, knowing that with one shot they could live," said Dr Irene Lubega, a paediatrician at Mulago Hospital in the Ugandan capital, Kampala. "It really breaks my heart to see children dying when you know it can be prevented."