In response to a request by the May 2008 Executive Board (EB) of the World Health Organization (WHO) to assess the feasibility of measles eradication, the WHO Secretariat has performed a detailed and independent technical analysis of the various aspects of the feasibility of eradicating measles. The results of this work were reviewed during the global technical consultation meeting, and the recommendations were made by an independent ad hoc Global Measles Advisory Group. This report summarizes the key meeting findings and the recommendations of the ad hoc Global Measles Advisory Group. This report will be presented to the WHO Strategic Advisory Group of Experts (SAGE) in November 2010 for their review and recommendations as to the feasibility of measles eradication. Although measles mortality has been substantially reduced, measles continues to cause preventable childhood deaths in many countries. Although rapid progress has been made in recent years, there is a real risk that measles will reemerge as a major cause of childhood mortality unless urgent actions address inadequate implementation of measles mortality reduction strategies in some countries. These include weakness within immunization systems, cross-border transmission of measles virus, and insufficient political will and financial resources. A comprehensive review of available evidence has established the biological (related to the properties of the disease and the virus) and technical (related to the properties of the vaccine and diagnostic testing) of measles eradication. An operational model has been demonstrated to be effective in the entire American Region and in a number of countries in each remaining WHO Region. In addition, measles elimination has been shown to be cost-effective in the American Region, and global eradication is assessed to be cost-effective. Thus, the ad hoc Global Measles Advisory Group concludes that measles can and should be eradicated. The interim measles control objectives established by the World Health Assembly (WHA) in 2010 should be actively pursued and will serve as milestones to eradication, while supporting the achievement of Millennium Development Goal 4. They include: First-dose measles vaccination coverage of at least 90% at the national level and 80% in all districts Reported measles incidence of <5 cases per million population At least 95% measles mortality reduction, compared with 2000 Given that the Region of the Americas has achieved and maintained elimination since 2002; that the European and Eastern Mediterranean Regions have target dates for elimination by 2010, which may be postponed to 2015; that the Western Pacific Region has a target date for elimination of 2012; and that the African Region has established a target date of 2020, the ad hoc Global Measles Advisory Group concludes that the WHA should consider establishing a target date for measles eradication once the South East Asian Region has established an elimination target. Acceleration of activities and measurable progress towards achieving the 2015 WHA measles targets would make it feasible to accomplish global eradication by 2020. Building the required political, social and economic platforms for measles eradication is both a disease control opportunity and an important developmental opportunity, requiring a broad multidisciplinary partnership. The success of measles eradication will depend on strong management, accountability, communication, advocacy, and resource mobilization at all levels. At the country level, measles eradication should be conducted within the context of Expanded Program on Immunization (EPI) activities, with each country taking responsibility for providing the necessary resources for strengthening immunization systems, including robust routine immunization programs and supplemental immunization activities, disease surveillance, program monitoring, and an integrated laboratory network. Responsibilities at the regional level include country coordination, technical support, and special assistance for countries with weak immunization systems. Global-level responsibilities include global leadership and management, coordination of policy and strategies, broad-based partnership facilitation, resource development, and the creation and implementation of a supportive research agenda. At all levels, linkages should be maximized with other child survival and disease control initiatives. Measles eradication activities should be used to accelerate rubella control and the prevention of congenital rubella syndrome. To this end, all countries that are introducing a second dose of measles vaccine into their routine immunization program should consider the use of measles-rubella (MR) or measles-mumps-rubella (MMR) vaccine. To review the outcomes of work done to assess the feasibility and economics of measles eradication To provide recommendations on the timing and nature of the next global goal To provide recommendations on research and additional programmatic work needed to facilitate measles eradication. The ad hoc Global Measles Advisory Group of experts participating in this Global Technical Consultation addressed the following specific questions: Should measles be eradicated? If “yes,” when is the appropriate target date? What else needs to be in place before an eradication goal is set? If “no,” what level of control should be targeted? What are the key areas of work, including research, needed to facilitate eradication? What does the group recommend as the best approach and/or strategy for achieving measles eradication? The WHO invited experts in measles, disease eradication, vaccine and immunization science, public health, health care systems, and economics from a variety of organizations, including ministries of health, the organizations and partners of the Measles Initiative (launched in 2001, the Measles Initiative is an international partnership committed to reducing measles deaths worldwide that is led by the American Red Cross, the Centers for Disease Control and Prevention, the United Nations Children’s Fund [UNICEF], the United Nations Foundation, and the WHO; more information is available at http://www.measlesinitiative.org), universities, and nonprofit institutes, as well as independent consultants, to advise the WHO on measles eradication. The meeting was chaired by Professor David Durrheim of the University of Newcastle, Australia. Drs Okwo Bele and Jon Andrus welcomed participants on behalf of the WHO and the Pan American Health Organization (PAHO), respectively. Dr William Foege, of the Bill and Melinda Gates Foundation, gave the keynote address and noted that eradication contributes to reductions in health inequities and that measles eradication might serve as the “tugboat” that leads to stronger immunization systems. He suggested that measles vaccination coverage be used as an indicator for the allocation of Global Alliance for Vaccines and Immunization (GAVI) funds. In addition, he stressed that we must avoid the paralysis caused by demanding certainty before making worthwhile public health decisions. With smallpox eradication, there were few competing priorities, whereas for measles there are many. The price of not choosing an eradication goal is the eternal risk of and in all countries. Dr of the WHO presented the objectives of the meeting and of work to assess the feasibility of measles eradication. The work has been conducted in a with by the WHO Group on Measles and the WHO Immunization and Vaccines Advisory and it the following biological vaccine on health care systems, economic risk analysis for the and political feasibility in the global Dr of the WHO reviewed global progress towards measles mortality reduction, as of the strategies used since 2000 have been effective in reducing mortality from measles by He key by worldwide that have rapid progress in reducing measles and mortality the of measles vaccine in the and in the the strategy for of measles vaccine in which was to by the Measles and the of laboratory for of measles and measles used by the Global He noted that measles mortality reduction for of the in mortality of and 2008 and that this can be by an of financial resources. as the for program and communication, and to strategies and Although immunization activities have made a major to measles the of routine which for of all measles deaths should be in routine vaccination is for routine vaccination to measles eradication should be as of an eradication The and of disease surveillance, and mortality must be to program and progress towards and Although the Measles Initiative has financial to to including from American Red and for financial a major to achievement and progress an eradication a disease of caused by a to measles virus, was in in following vaccination that in the The group was that an of eradication was in 2010, which for the biological feasibility of eradication of Dr an of from the eradication and noted the of operational The that a of operational feasibility in all population and in with weak health should be to the feasibility addressed at the meeting biological economic vaccine and programmatic This would to be of in the of measles, that the for success would be with a global of the of the The of eradication is of an in the Americas may be a necessary for global it may not be for making the to from measles control to eradication with major and He that management, technical robust effective that to the level, financial support, and research and will be He suggested countries the required was and routine coverage was as a of operational feasibility of measles eradication in the and a comprehensive approach are required for disease control and eradication of financial is a we can be that resources will be available when it would be to an eradication eradication, were and many countries not eradication activities before the target date to the should not the real of measles eradication or the financial of Measles is from with measles, there is virus, not vaccine are for and with measles, not to the In measles eradication is to be to was eradication. 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A 2011 study studied this question.