Mar 05, 2011 Volume 377 Number 9768 Pages 783 – 874
Athalia Christie, Andrea Gay
The recommendation by David Heymann and colleagues (Nov 20, p 1719)1 that high routine immunisation coverage be a prerequisite for measles campaigns or a measles eradication goal disregards current policy and the progress made in the past decade.
David N Durrheim, Hyam Bashour
David Heymann and colleagues1 consider progress towards regional elimination of measles a distraction from polio eradication efforts. However, measles vaccine has proven one of the most cost-effective measures for saving vulnerable children’s lives. Attaining high coverage of measles immunisation worldwide represents one of the most effective propoor strategies available.2
Jon Kim Andrus, Ciro A de Quadros
We share David Heymann and colleagues’ concern that “any eventual strategy for measles eradication should truly strengthen routine immunisation and should not become a substitute”.1 Simply put, any measles eradication strategy should strengthen the overall health system’s capacity for improved surveillance and delivery of services, not just immunisation. That was the experience with the eradication of poliomyelitis, measles, and, more recently, rubella and congenital rubella syndrome in the Americas.
Measles eradication – Authors’ reply
David Heymann, Paul E Fine, Ulla K Griffiths, Andew J Hall
We welcome the comments on a proposed measles eradication strategy, and the further debate on measles eradication that has ensued. That, in fact, was our hope as we wrote the Comment about potential measles eradication strategies. As the correspondents point out, measles elimination—which includes periodic measles vaccination campaigns—is currently underway, and five of the six WHO regions have set elimination targets. Elimination is not eradication, although the terms are often confused.1