1. Global Overview of Measles & Rubella 11 th Annual Meeting The Measles Initiative Washington, DC 18-19 th September, 2012

2. Major causes of annual under 5yrs child mortality: 1990-2010 2000 : 9.6 million 2010 : 7.6 million Source: Li, Liu, at all The Lancet 379, June 9, 2012): 1990: 12.1 million 2008: 8.8 million Source: Van den Ent et al, J Infect Dis Suppl July 2011

3. Estimated measles deaths down by three - quarters, 2000 - 2010 2015 Target 74%

4. 4 |4 | Trends in 1 st and 2 nd dose Measles delivery various strategies Number of doses of measles vaccine administered, by delivery strategy, 2000-2010 Measles Initiative 1 st routine dose: WHO/UNICEF coverage estimates, The World Population Prospects New York, 2011. 2 nd routine dose: WHO/UNICEF Joint reporting form, (not all countries report 2 nd dose). SIA dose;: WHO SIA database, July 2011 (Provisional data) 1 billion vaccinated as of July 2011

5. Measles and other interventions supplementary activities, 2011 Vitamin A – 12 De-worming – 10 Bed nets – 2 OPV – 16 Other interventions -5 WHO;August 2012 *OPV+VitA+Deworming+Mealses

6. 6 |6 | 84% 2015 Target Annual Number of Reported Measles Cases and 1 st Dose Measles Vaccination Coverage, Worldwide, 1980-2011

7. 7 |7 | Reduction in Estimated Measles Deaths by WHO Region 2000 to 2010 74%76%79%85% 2010 reduction goal (90%) 78% Source: WHO/IVB, November 2009 87%100% 26%

8. 8 |8 | Pareto-Juran principle 20% of the work (the first 10% and the last 10%) consume 80% of your time and resources

9. 9 |9 | India Phase 2 (157 districts) Phase 1 (45 districts covered) Remaining (159 districts) Source: Based on target population available with GoI Target pop (millions) Vaccinated (millions) Coverage Phase-113.812.188% Phase-242.928.667%* Phase-372.7Planned-- Total129.440.7*-- * Phase-2 campaigns ongoing; data as on 23 Jan 2012. 17 states with MCV1 coverage ≥ 80% introduced a routine second dose by August 2011. 14 states with MCV1 < 80% are implementing measles SIAs

10. 10 | Measles and Rubella Elimination Goals by WHO Region, February 2012 2015 2015 2015 2012 SEAR: 95% Mortality Reduction by 2015 Americas, Europe, E. Mediterranean, W. Pacific, Africa have measles elimination goals Americas and Europe have rubella elimination goals 2020 2000 2010

11. Political advocacy, mobilizing decision makers Branding, advertising & ‘edu-tainment’ with national, provincial and community mass media Community engagement Meetings, forums, film showings and events Targeted selling Volunteer Social Mobilization Networks Point of service promotion Inter-personal communication Researched & Evidenced multi- pronged communication: Experience from GPEI COMBI Star adapted for polio eradication Challenges 1: Communication

12. 12 | Challenges 2: Weak Immunization Systems 1 st dose: –67 Countries have MCV1 coverage < 90% 2 nd dose ( routine ): –54 countries do not have routine 2 nd dose Campaigns: –Variable quality Measles 1 st dose coverage among infants, 2010 80-89% (24 countries or 12 %) 50-79% (41 countries or 21%) >=90% (126 countries or 66%) <50% (2 countries or 1%)

13. 13 | Challenges 3: Some set backs in Africa 4-fold increase since 2008 Large outbreaks in Burkina Faso (2009), S. Africa (2010), and DRC (2011) Outbreaks in drought affected Horn of Africa –High case-fatality Weekly Epidemiological Record (2011) 86:129-135

14. 14 | Historical procurement of Measles and MR vaccine through UNICEF in 2000-2012 and forecasts for 2013-2016 (in doses)

15. 15 |SummarySummary Achievements –1 st dose coverage up to 85% –1 billion doses delivered in campaigns –2 / 3 reduction in cases –3 / 4 reduction in deaths Challenges –Catch - up in India; Outbreaks in Africa; Weak systems New Strategic Plan, 2012 – 2020 –Addressing rubella together with Measles –Taking the Initiative towards achieving regional goals More Harambee