Partners for Measles Advocacy—7th Annual Meeting 27-28 Feb 2007

Meeting Objectives To report on progress of Yr 6 and Yr 7 priority activities To explore additional integration of health initiatives, particularly malaria prevention To report on and discuss resource mobilization and communication activities

Introduction-”What is past is prologue” Achievements: 1999-2005 60% reduction in measles mortality 2.3 m deaths averted >360m children vaccinated MCV1 54%-65% Lessons learned Importance of partnership Integration Mobilization/awareness/advocacy Challenges Sustain the gains Pakistan and India $$$$$

Measles Control Goals by WHO Region Americas, Europe, E. Mediterranean, W. Pacific have elimination goals GIVS Goal: 90% reduction in deaths by 2010 (vs. 2000) 2010 2010 2012 This map shows the 192 member countries of WHO grouped into 6 regions with their respective measles control goals. 4 Regions (Americas, Europe, E. Mediterranean and W. Pacific) have measles elimination goals with target dates as shown and 2 regions (Africa and SE Asia) have measles mortality reduction goals. The overriding global goal established by the World Health Assembly is to reduce measles deaths by half by 2005. 2000 Africa and SE Asia have mortality reduction goals

Reaching Measles Goal 2010-Can we get there? Epidemiology/program Major gains but challenges to sustain (e.g followup) Global goal but regional variation MCV1 improving but far from adequate SIA integration ongoing but challenges Surveillance priority but different indicators Partnership Need to include civil society Need $479m 2007-10 (gap: $281m) Supply Challenges to vaccine security

Tackling Big Challenges Pakistan and India Challenges: low MCV1, huge target pop, surveillance, competing priorities, ?resistance Progress: commitment to EPI and measles—SIAs, TAG—next steps? Global vs. National priorities/timelines? Strengthening routine EPI-AFR,EMR Progress: different stages but w/ general reliance on RED Challenge: intra-national variation, expanding >80%, importance of key national managers

Challenges, con’t Discussion: routine--SIA Need for a diagonal approach to reach common target of reducing morbidity and mortality Utilization of polio infrastructure can be essential for both surveillance and implementation Opportunities for advocacy--Challenge to identify discrete targeted indicators

Expanding the Benefits through Integration Progress: M&M Steady increase in ITN distribution (30m) w/ extraordinary results (e.g. SL) Lessons learned Role of leadership and partnerships Importance of community (“public”) participation—developing “net culture” Challenges Operational issues—logistics, options, safety, $ Measurement of impact— ITN distribution in Togo, Niger, Mozambique Sustainable decentralized, integrated system Sustaining gains and breakthrough?

Integration, con’t Discussion Dialectic between routine—SIA? Further need to measure impact-- disease? Interaction w/ EPI program? Working groups—practical next steps Operational research GFATM—develop standard proposal? Communication

Outbreaks, Emergencies, SIA Importance of data: surveillance to detect outbreaks, outbreak case data, link to EPI program data Data can give false sense of security Emergencies give visibility—advocacy? M&M SIA quality Need sufficient preparation time and data driven plans Importance of M&E—review linkages? EPI platform requires further training, staff, ops $, and support Importance of partnerships—public health approach Need for new specific M&M SIA guidelines?

Final summary 2005 goal: “We did it” 2010 goal: “We are better educated as to challenge and how to get there” “When the nose of the camel goes into tent you get the whole camel” Future: “We have a moral imperative to work together”