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Measles next?

Sudan - three children in one family left permanently blinded by measles and malnutrition.
Unlike polio, measles is not a word to strike fear into populations. In the industrialized world the disease is usually little more than a nuisance, and even in the developing world a majority of the children who contract measles recover with no apparent ill effects. But between 2% and 4% do not recover. And that means 1 to 2 million child deaths each year.

The tragedy does not stop there. Many of the survivors suffer from malnutrition and vitamin A deficiency, pushing up death rates in the year or so after a measles attack.

The good news is that measles could be the next major disease to be eradicated after polio.

Immunization of children against measles has risen from about 25% in 1980 to almost 80% today ­ an effort that is now preventing about 1.5 million child deaths a year.

But even high levels of routine immunization will not be enough. As with polio, national immunization days followed by the monitoring and blitzing of any outbreaks will be needed to eliminate the disease.

Latin America, the first region to eradicate polio, is also leading the way towards measles elimination. Most nations have held national immunization days, and the region as a whole aims to be clear by the year 2000.

Measles takes its heaviest toll in sub-Saharan Africa where only two nations, Malawi and Mauritius, have reached 90% immunization coverage.

Unlike the anti-polio effort, measles elimination has so far failed to attract the necessary political and financial support. In Indonesia, the 1994 national immunization day was scaled back to polio only because of lack of funds.

Ending measles is as feasible as ending polio. The strategy is clear and the low-cost technology is available. There is now no reason why a disease which has for so long been one of the main causes of death and malnutrition among the world's children should not be eliminated within a decade.

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