| Measles
In 2001, WHO and UNICEF jointly agreed to a
Global Measles Mortality Reduction and Regional Elimination Strategic Plan 2001−2005
which was then endorsed by the United Nations Special Session on Children in
May 2002 and the Fifty-Sixth World Health Assembly in May 2003. The global goal is to reduce the number of
measles deaths by half by 2005 relative to 1999 estimates. South-East
Asia’s contribution to this is to work towards attaining this
goal in polio-free countries of the Region, through the regional strategic
plan prepared for 2003−2005 that was endorsed in June 2003 by the
regional Technical Consultative Group.
This also fits within the targets set globally by WHO
to define and implement control and elimination strategies for priority
diseases and conditions that are vaccine preventable.
Regionally measles is the commonest cause of
childhood death due to a vaccine-preventable disease and remains a major
cause of both morbidity and mortality. Global estimates of measles deaths
indicate that as many as 202 000 deaths (29% of the estimated global figure)
occurred in the Region in 2000 despite an increase in routine measles
immunization coverage and a corresponding decline in measles cases. The continued high burden of measles cases
stems primarily from underutilization of measles vaccine and inadequate
vaccination coverage due to weak immunization services. Data on measles cases and deaths are
available in the Region but both are grossly under-reported.
MNT
Neonatal tetanus is an important cause of
death from vaccine-preventable diseases among children worldwide. With a case
fatality rate of close to 100% in the absence of hsopital
care (and 10-60% where care is available), globally an estimated 180 000
infants die each year from neonatal tetanus (figure for 2002). That same year
11,624 NT
cases were reported, compared to an estimated 218,000 cases actually
occurring, i.e. on average, only 5% of NT cases are actually reported. For
this reason, the disease is called "the silent killer". Maternal
tetanus is responsible for up to 15,000 to 30 000 deaths annually. In 1998,
globally, 27 countries accounted for 90% of the estimated neonatal (NT)
cases. Five of these 27 countries were in the South-East Asia Region (Bangladesh, India,
Indonesia, Myanmar and Nepal). Since then a lot of
progress has been made. Nepal
has been validated as having eliminated MNT.
Further 13 States and Union Territories of India have been validated as
eliminated NNT(data as of Jan08).
The goal of elimination of neonatal tetanus
was set by the World Health Assembly in 1989 , and
subsequently endorsed by the World Summit for Children in 1990. By 2000, 157
countries had achieved elimination but MNT remained
a significant problem in 57 countries. As a result a new five-year strategic
plan was agreed by WHO, UNICEF and UNFPA setting the
year 2005 as the target date for worldwide elimination of maternal and
neonatal tetanus. As of January 2008, 47 countries remained that had not
eliminated MNT including 5 countries ( Bangladesh, India,
Indonesia, Myanmar and
Timor-Leste) in SEAR.
Sources:
- Roper M et al: Maternal and neonatal
tetanus. Lancet 2007; 370: 1947-1959
- WHO, UNICEF, UNFPA: MNT
Elimination by 2005 (Nov 2000)
- JRF data for 2006
and 2002 in WHO VPD Monitoring System 2007 Global
Summary (page 19).
|
