1 1 Measles elimination and rubella control in the SEA Region- a brief Update 12 th Annual Meeting of the Measles Rubella Initiative (MRI) September, Washington DC

2 2 Progress in immunization against Measles and rubella, SEA Region, 2000 to 2012 Coverage with 1 st dose measles vaccine increased from 61% to 79%; 6 countries with 1 st dose coverage >95% 10 countries introduced 2 nd routine dose of measles vaccine 10 countries have conducted wide age-range measles supplemental immunization campaigns; 8 have conducted follow-up measles immunization campaigns 7 countries use rubella vaccination in combination with measles and or mumps vaccine Wide age range campaigns with Measles and rubella vaccine in Nepal in 2012; Bangladesh in 2013 India achievements in the past two years  2 nd routine dose of measles immunization in 21 States  Campaigns in 14 States – 139 million children aged 6 months to 10 years

3 3 Impact on measles burden SEA Region, 2000 to % decrease in measles cases 70% decline in measles deaths by 2011 in all Member States except India (48% overall) 63% decline in measles incidence rate from 69.9 per million population to 25.0 per million Bhutan, DPR Korea, Maldives and Sri Lanka may have eliminated measles (and rubella in Sri Lanka) Improved knowledge of circulating measles and rubella genotypes

4 4 MCV1 Coverage for SEAR countries,

5 5 Setting the stage for measles elimination and rubella/CRS control in SEA Region At the meeting of the SEA Regional Committee this week, a resolution is being considered for adoption setting 2020 as the target year for the elimination of measles and rubella/CRS control in the WHO South-East Asia Region A detailed strategic plan with costing is already developed A measles surveillance workshop will be held from September to strengthen country measles/rubella/CRS surveillance in preparation towards the achievement of the goal of measles elimination and rubella/CRS control in SEAR by 2020 A massive measles campaign, targeting more than 52 million 9 months to 15 years of age children is to start in Bangladesh from 2 November 2013 An integrated polio/measles surveillance started statewide for UP in India, possibly the largest such surveillance activity

6 6 Key challenges Securing and maintaining political commitment  Success in polio; "Can do" spirit  Regional Committee’s engagement  Commitment to intensification of routine immunization  Solidarity with other Regions Ensuring adequate funding (Approx. USD780 millions excluding additional cost of increasing RI coverage >95%)  National financing important  External funding necessary Making available adequate vaccine supply Establishing case based surveillance for measles/rubella Applying the lessons learned from polio  Reaching the unreached Large countries – herd immunity; scale of operations

7 7 THANK YOU