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Eliminate measles, says expert

2003-10-15 17:24
line

Somerset West - Governments should be aiming at virtually complete elimination of measles deaths by 2005, not a 50% reduction, a South African expert on the disease, Prof Greg Hussey, said on Wednesday.

Hussey, head of the paediatric infectious diseases unit at the University of Cape Town, was speaking in Somerset West at an international conference on measles convened by the World Health Organisation (WHO) and the United Nations Children's Fund.

The United Nations has set a target of halving measles deaths, which currently total about 745 000 a year worldwide, by 2005 compared to 1999 figures.

Some 200 delegates from 60 countries are attending the three-day conference, the first of its kind. They include representatives of the 45 WHO "priority" countries - most of them in Africa - that carry 95% of the burden of measles deaths.

Hussey was appointed last month to chair an international panel to review the WHO's anti-measles strategy, and will be presenting its interim findings to the conference on Friday.

He told Sapa that the 50% goal was reasonable, but added: "I would go so far as saying there should be virtually a complete, hundred percent reduction. That's not unreasonable, given all the issues."

Arms instead of health

He echoed one of the speakers at the conference, the internationally acclaimed Dr Ciro de Quadros of Washington's Sabin Vaccine Institute, who earlier criticised governments for spending money on armaments instead of health.

"The amount of money we spend in Africa on arms... If you speak to anybody who's an economist, they'll say, for what, one battleship, or one warplane, you could probably immunise all the kids on the continent," said Hussey.

He said measles vaccination, which the WHO says has proven both safe and effective, was a clear-cut issue.

"I mean, the vaccine is so cheap. It virtually costs nothing, and here's something we can to do save the lives of children."

In Cape Town in the early 1990s, the city's hospital for infectious diseases, where he worked at the time, had two wards filled with children with measles, one in ten of whom died.

"And this is ten, 15 years ago," he said. "If you look at the gains we've made to date, ten years later, we've closed the hospital. I worked myself out of a job. And it was purely on the basis of making sure that kids actually get their vaccines.

"So, I think the answer is simple. Vaccines are cheap, they work; I think the issue is getting them to lots of people that need them.

200 deaths a day

Earlier, De Quadros, who is Sabin's director of international programmes and a former WHO director of immunisation and vaccination for the Americas, told delegates that 2 000 children across the globe would die of measles every day that the conference was in progress.

"Why have we abandoned our children? Why are we committing this crime?" he asked.

De Quadros said it was true there had been great progress in preventing the spread of measles. However, children still continued to die by the thousands.

"In my opinion this is morally unacceptable... children have the human right not to die of measles. We have a moral obligation to provide every child with this vaccine."

He said he found it "a little bit difficult" to accept that even impoverished countries, such as Mozambique, could not afford measles vaccination.

"Because even the poorer countries, they buy lots of guns, don't they? Aeroplanes, Kalashnikovs. So they have money for some things."

WHO regional director for Africa, Dr Ebrahim Samba, also told delegates he believed the global community could do even better than meet the UN goal of reducing measles deaths by half by 2005.

Renewed commitment

However, this called for renewed commitment and dedication.

"We can do it... we should continue and eliminate measles from the surface of the earth," he said.

The department of health's director for child and youth health, Estelle de Klerk, said in a message read on behalf of Health Minister Manto Tshabalala-Msimang - who is in India - that measles vaccination was perhaps the most cost-effective public health measure available to governments.

"We appeal to the donor community to include generous support for measles vaccination in their plans of action for the rest of this decade," she said.

"They will secure no better return for their funds."

South Africa, which had an average of 20 000 measles cases a year in the 1980s, now enjoys a zero mortality rate, thanks to vaccination campaigns in 1996/97 and 2000.

There are now fewer than 100 laboratory-confirmed cases in South Africa every year.

De Klerk said this was one of the most important public health achievements in South Africa's history.

The formal sessions of the conference will be followed on Friday by the adoption of the Cape Town Measles Declaration, committing governments and international agencies to intensify the battle against the disease.

- SAPA

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