WHO Briefing on Measles 10 November 2020

OK.

I'm told that we can move right into this this item.

So Fadela Shahib again, from WHO where I will let you introduce your guests and the topic and then we'll take it from there.

Thank you, Real, and thanks to journalists who stay to, to be briefed about a very important topic for W2.

It's the it's measles.

We W2 and the CDC are very regularly publish updated data on the on, on measles.

And we have new data.

The embargo is set for this Thursday, 12th November at 7:00 PM.

You were sent this morning a document with the outcome of this report.

We wanted to brief you about it with Doctor Kate O'Brien, but because the briefing was taking too long, she had to to go to another commitment.

But we are very lucky to have with us Doctor Natasha Crawcroft.

She is our senior technical advisors for measles and rubella.

So you will have a press release, I hope, in the course of the day or tomorrow.

And they're on Bargo for Thursday, 7:00 PM.

And you will be briefed now by Doctor Crowcroft on the outcome of the report, the WHOCDC report.

Thank you.

Thanks very much, Fidela.

So I'm Natasha Crowcroft and I'm the senior technical advisor of The Who for muses in Nazela.

So I'm really, I think this is really important work that's coming out and I and I really thank you for staying on for for this.

Is this so it's, it's a report on on data that's being issued from 2019 plus also the launch of a new strategy.

So I'm going to say a bit more about that.

So the good news is that measles vaccination has saved more than 25.5 million lives globally since 2000.

So those are updated numbers.

The problem is that progress towards the elimination targets has stalled and and so that stalling in our progress has led to record **** increases in the number of new infections and measles death.

The data we're going to release shows that measles deaths climbed 50% in 2016, which was the low point in the last two decades to 2019 in a relatively short period of time, claiming 207,500 lives in 2019.

These are all preventable deaths.

The estimated number of measles cases in 2019 represents the highest number that's been reported in 23 years, 869,710 cases.

And there are increases in all WHO regions.

The the annual reported deaths in 2019 were highest in 13 years since 2006.

And of the countries reporting data in 2019, there's just nine countries actually accounted for 73% of all the cases.

So it's really focused in vulnerable communities in particular, and that's one of the reasons that deaths increased so much in 2019 compared to 2018.

Many large outbreaks in in really vulnerable communities with limited access to good Primary Health care, poorer levels of health, malnutrition, leukinosis, efficiency, and all of those things increase severity and the impact of musings.

As you likely know, measles is extremely contagious and the risk of measles transmission is very **** when communities, especially across international borders, when there's movement of people.

But against this dangerous backdrop, we're adding on the impact of the COVID-19 pandemic.

So many measles backstation campaigns have been delayed or suspended.

We've currently got campaigns delayed in 26 countries.

Only eight countries have managed to restart their campaigns.

Routine immunisation, which has also had been disrupted, is is beginning to recover.

But if we're going to get back on track, countries really need to reach and maintain at least 95% immunisation coverage with two doses and the needles containing vaccine.

And they need to be really quick to identify children that are going to miss and close any of the limited gaps that have been widened in this time to try and reduce the impact of the disruptions due to the COVID-19 pandemic.

So one of the pieces of work that we're going to try and address this issue, you may have heard about the call to action last week, which is a tool to get funding to close those immunity gaps in the longer term to try and get immunisation programmes back on track and to turn around the stalling in programmes that we were talking about the the stalling and increases in in immunisation coverage.

Debich has worked with partners in developing measles and Uballa strategic framework and that also has been launched along with these publications on Thursday.

And this is a 10 year strategy to accelerate progress towards measles and uballa goals and to really drive change in the immunisation programmes and systems building on Immunisation Agenda 2030 and to improve primary access to Primary Health care and to improve all the systems around immunisation and to try and envisage what we're talking about.

You imagine that a child is brought forward by her mother for her first dose of of measles vaccine and at the clinic is welcomed by friendly, well trained staff working in a facility that has regular supplies of vaccines, where the government fully supports immunisation programmes as part of essential priority health healthcare.

And the the nurse receives the mother and the child cheques which vaccines the child has had not just measles, but all asks about older siblings ask about about the mother thinks about other health interventions that child might need, but takes a really integrated and comprehensive approach.

Has access to everything they need in terms of delivering the vaccines the child needs on the day.

Any vaccines that child or their siblings made in this gives other health advice and sends the family off, having carefully recorded the information with anything else they might need.

For example, bed Nets or information and reports any and reports information on what's happened that day as well in a way that means that the country can really guide and make decisions about immunisation programmes based on really good quality information.

So that's my way of trying to capture the idea of a strategic framework, which is kind of dry kind of document, but in terms of what we really want to see on the ground.

And that's where it really matters when it comes to immunisation.

So I am, I'm happy to answer any questions and we have the the press released so far.

There will be other materials to follow and maybe I can hand back to Geller.

Thank you.

Thank you very much, Doctor Crowcroft.

We're going to take a few questions on this very important topic.

Lisa Shlyne from Voice of America would like to ask a question.

Please go ahead, Lisa.

Yes, good morning, Doctor Crockhoff.

Nice to have you there.

Unfortunately, the audio was not brilliant.

In fact, it was rather difficult to hear a lot of what you have to say.

I'm sorry about that.

I don't know whether you can regulate that or not.

But anyway, I do have some questions and that has to do with you mentioned that there were nine countries that were most affected.

Where are they?

Are they in Africa?

I believe that the DRC is one of the maybe the country most impacted by measles.

If, if you could discuss the situation, highlight the situation in Africa.

And then I'm wondering now, why is it that there the immunisation rates have gone down so radically?

Is it because of lack of money, because of the anti vaxers, vaccinators who, who are there?

Who I don't know, these crazies who say that, they don't say anyway the anti vaccinators or whether it is the the impact of COVID-19 and the inability, well the competition and also the inability of people to leave safely and get vaccinated or maybe all of the above.

Thank you.

I apologise for the audio.

If I come closer to the mic, is that better?

It does help, yes.

Thank you.

Get yes.

I think that's a little.

Bit better.

OK, I'm sorry.

I apologise for that.

Then I'll, I'll try shouting as well.

So in, in terms of the countries that are affected, they're not all in the African region.

They were, there were very large outbreaks in the Democratic Republic of Congo and in Madagascar and Central African Republic has many cases, but other countries are affected.

Every region was affected by increases.

So it's not just in the African region.

There were big outbreaks in Georgia and Kazakhstan, N Macedonia, Samoa, Tonga and Ukraine.

So really every part of every region was affected by outbreaks and those are the large ones.

In relation to the it's not, but the big issue is not actually large falls in coverage, it's the stalling in coverage.

So coverage climbed in the first decade of from 2000 and then in the second decade from 2010 to now has been flat at around about 83 to 84%.

And the problem with that level of coverage is it is **** enough to have an impact certainly on measles and to prevent deaths in cases, but it also means a large proportion of children are missed.

And those children that are missed, they accumulate year on year until they reaches a point, it's a bit like, you know, Tinder for, for a forest fire.

It reaches a point where an outbreak really takes off.

And that's what we saw in 2019 with the almost explosive outbreaks in areas that have had inadequate coverage over many years.

In fact, if you have even worse, if you have very, very low coverage, you get, you get epidemics every year.

But if you have coverage around about that 80% level, then you get the sense that things are going OK and then they're not really.

And eventually you see these large outbreaks.

Your question about vaccine hesitancy is really important because that's the question I get asked about so often, and it's vaccine hesitancy is important.

I don't want to discount it in any way, but when you look at the situation globally, it's not the number one issue.

The real issue is weaknesses in health systems and the inability to reach children with vaccines at all.

Vaccine hesitancy was layered on top of that and it certainly has caused issues in some specific outbreaks.

But in the generality, the really big outbreaks we've seen, the vast majority is to deal with with with health systems not reaching enough children, immunisation campaigns not reaching enough children.

So that's not the number one issue that we need to we need to address, although it's one of the issues we do need to address.

I think I've covered all your questions.

Sounded very, very exhaustive.

Thank you very much.

We have another question from Gabriela Sotomayor, a Mexican journalist.

Gabriela.

Thank you.

Thank you, Real.

Hi, Good morning.

Doctor Crow, there was a concerning outbreak of missiles in Mexico.

So are are you aware of this situation?

And I would like to know if it's under control.

Thank you very much.

Thank you for your question.

This I, I had, I don't have the data on Mexico.

I am aware that there's an issue, but I don't have the data to hand, so I'm not able to speak to it right now.

But if you want to contact us, we will try and address any questions you have about it.

The focus of this release is about 2019 data so I I can't speak to it right now.

Very good.

Yes, Lisa Schlein, another question.

Yeah, unfortunately your audio deteriorated again.

But I'll ask my question in in regard to Africa's well all over.

But also I asked if you would talk a bit more about the situation in the DRC, which I think is the most heavily impacted country.

But what is the remedy?

What are you asking for in this time of COVID and then in resources which aren't available, how can you remedy this situation and stop the increase in this epidemic of measles?

Thank you, Lisa.

So there are several different strategies available.

And in this time of COVID, the, the number one action we need to take is to prevent outbreaks from happening in countries where it's where it, where it, where we've got the highest risk.

So you mentioned the Democratic Republic of Congo in, in settings where and there are, and there are several where the there isn't the ability to, for the, the health system in place to be able to rely on putting on.

You can't strengthen Primary Health.

Sorry, I'm, I'm being a bit slow about this.

You can't strengthen, strengthen primary healthcare systems overnight.

It's a long programme and there are countries that are much more imminent risk of outbreaks.

So This is why we had the call to action last week, which is to get funding to try and address imminent risk of of outbreaks in **** priority areas.

So WH has worked with the regions to identify the countries we we think are the greatest risk and we've had a call for funding to help with identifying where outbreak risks are and putting in place prevent preventive immunisation campaigns.

So it's a, it's a different strategy to what I was talking about in terms of the measles rubella strategic framework, which is a 10 year building for the future and trying to stop us getting into the situation we're in now in some countries where we're worried there will be more outbreaks imminently and COVID has increased that risk.

I hope I'm does that answer your question.

It, it sounded quite exhaustive.

Thank you.

And we'll take one more question from Nina Larson.

AFP.

Yeah, Hi.

Thank you for taking my question.

I also was having some trouble with the audio.

So I'm sorry if I'm asking you a question that you've already answered, but it was more on the, on the impact of, of COVID on, on vaccination that you mentioned that the that drops or when the vaccination is remain stable and doesn't go up, there's a cumulative effect.

So I'm wondering what the cumulative effect will be from the, the dramatic drops that we've seen that we've seen this year amid the, the COVID outbreak.

How, what you think the long term effects of this will be?

Thank you.

Thank you, Nina for your question.

So we, we don't know yet.

We'll have to evaluate that, but it looks like routine, the routine in what we call routine immunisation.

So this the the, the standard way children get immunised, where they go to the clinic, they have an appointment, they get immunised at the right age in countries where there are good systems that took an early step back in most of the world as everyone was trying to figure things out and then has recovered.

So for for countries that are in a were in a good place at the beginning, they are doing a good job to recover those gaps.

But in inevitably, as is the way of the world, in the countries that were weakest at the beginning, they've had the most issues in trying to, they were already having trouble and are now having more issues because they've had to delay immunisation campaigns.

And so I, many of us have concerns that unless we really take action very quickly to address these widening gaps in countries that we've identified as being at **** risk, those countries will experience outbreaks and more deaths.

And that's layered on everything you've been hearing today about the the impact of COVID on the health of communities more broadly, malnutrition, poverty.

So.

So that's why the immediate priority is to address the short term gaps, but the longer term is to build systems that mean they don't develop in the first place.

Very good.

I think that's all the questions we have, so we will end the briefing here.

Thank you so much Doctor Natasha Crocroft, Senior Technical Advisor on Measles and rubella at the World Health Organisation for being with us.

And I remind everyone that of course, the information that's been shared with you today is under embargo until Thursday, 12th of November at 1:00 PM Eastern Standard Time.

Fadela, is there anything you would like to add?

No, she, I think she's not there anymore.

So we will finish here.

Thank you very much for your patience and I wish you all a very good afternoon.

Thank you.