Political support, strong public health systems key to eliminating measles outbreaks worldwide

Strong political support and strong public health systems are necessary to combat measles outbreaks, which are growing in frequency around the world, argue public health experts in a commentary in CMAJ (Canadian Medical Association Journal).

"Sustaining measles elimination requires strong regional public health systems," write Drs. Natasha Crowcroft and Shelly Bolotin, Public Health Ontario and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario. "In a globalized society in which we are all connected, a disease as infectious as measles—the most infectious of the vaccine-preventable diseases—is easily spread. To prevent this, public health programs need to deliver close to 100% immunization coverage, which is challenging on a technical level."

The World Health Organization reports a 300% increase in cases of measles in the first 3 months of 2019 compared with 2018.

"In the war against microbes, victories are achieved at a huge price, and the peace that follows is fragile," write the authors. "It took many years for the Americas to verify elimination of measles in 2016. It took only 2 years of political disruption in Venezuela to disrupt the health system enough to obliterate this achievement."

Ensuring that everyone is vaccinated is complex and requires coordination at the local level, which is undermined by the pockets of anti-vaccination proponents. Strong public health systems are needed to ensure everyone is immunized and to track this uptake accurately.