1. Progress in Measles Control in the African Region Annual Measles Partnership meeting Feb 2007 Washington DC

2. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 2 Outline Regional goals Routine immunization Second opportunity for measles vaccination Disease surveillance Conclusions/ challenges Priorities for 2007

3. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 3 Estimated Reduction in Measles Mortality in AFR, 1999-2005 75% reduction 2005 Goal Source: WHO/IVB measles deaths estimates

4. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 4 Regional goal for measles control Reduction of measles deaths by 90% by 2009 as compared to estimates for 2000

5. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 5 ND Reported measles coverage. AFR. 2005 – Nov 2006 2005 50 - 79% EMRO <50% >=80% ND: No data Jan – November 2006 ND

6. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 6 Reinforcing Routine EPI Measles Partnership support for routine EPI amounting to 10% of operational costs coming through the WHO Total USD 2,711,429 between 2004 - 2006

7. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 7 A total of 297.4 million children reached. Measles SIAs. AFR. 2001- 2006

8. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 8 Target persons reached in measles SIAs. AFR. 2001 - 2006

9. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 9 Measles catch-up SIAs. Nigeria. 2006 < 85% 85 – 94% 95 – 100%

10. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 10 Financial support through the MP for measles control in AFR. 2001 -2006

11. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 11 Financial contribution to the catch-up SIAs in Southern Nigeria. 2006 Government of Nigeria: 31% costs of measles SIAs

12. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 12 Integration of multiple interventions during measles SIAs. AFR. 2006 All 17 countries integrated at least one intervention: Vitamin A: 12 countries Anti-helminthes: 7 countries ITNs:7 countries (mostly sub-national) OPV: 5 countries TT for WCBA: 1 country

13. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 13 The AFR measles surveillance and lab network. Feb 2007

14. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 14 Measles surveillance performance indicators in AFR. 2002 - 2006

15. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 15 Countries planning Measles SIAs in 2007 Target: 22.5 million (+ 9 million SoA) children in 16 countries

16. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 16 Inter-campaign interval for 2007 CountryAverage natl routine measles coverage (03 –05) Burkina Faso 79 Congo 57 Gabon 35 Gambia 88 Lesotho 60 Mali 89 Madagascar 76 Mauritania 65 Niger 74 Togo 71 Zambia 79

17. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 17 Inter-campaign interval for 2007 CountryAverage natl routine measles coverage (03 –05) Recommended SIAs interval in yrs (AFR TAG) SIAs interval in months acc. to PoA Burkina Faso 793 yrs35 Congo 572 yrs33 Gabon 352 yrs37 Gambia 884 yrs47 Lesotho 602 yrs53 Mali 894 yrs36 Madagascar 763 yrs38 Mauritania 653 yrs38 Niger 743 yrs28 Togo 713 yrs36 Zambia 793 yrs48

18. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 18 Integrated interventions planned during measles SIAs. 2007

19. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 19 Challenges Routine measles vaccine coverage is improving but not yet adequate even in the best performing countries: –Sub-national gaps leading to outbreaks SIAs integrating multiple child survival interventions –Risk of decreased funding availability (unpredictable in- country funding, increasing operational costs) –Need for better coordination Sub-optimal administrative coverage during follow- up SIAs

20. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 20 Priorities for measles control in AFR. 2007 Continue efforts to improve routine EPI coverage: –RED approach Continue advocating for more local resource mobilization for SIAs Capitalize on the opportunity for integration to ensure synergy – planning, coordination, funding…

21. Bureau Régional de lOMS pour lAfrique / WHO Regional Office for Africa 21 Thank you