Deaths as a result of measles fell by 60 percent worldwide between 1999 and 2005, it was announced this week by the Measles Initiative – a partnership between the World Health Organization (WHO), the United Nations (UN), the US Centers for Disease Control and Prevention (CDC), the American Red Cross and other organisations [1]. This figure surpasses the target set by the UN in 2002 to reduce deaths due to measles by half in this period. According to recently published data, the number of measles deaths worldwide fell from an estimated 873 000 (uncertainty bounds 634 000 to 1 140?000) in 1999 to 345 000 (247 000 to 458 000) in 2005 [2].

Measles is extremely contagious. Outbreaks in Europe remain common although fatalities are now rare: 12 deaths were reported in the European Union in 2005, 11 in Romania and one in Germany [3]. In many developing nations, however, case fatality rates range from 1 to 5%, and can reach 30% in refugee settings and among malnourished children. Despite there being a safe and effective vaccine available for over four decades, measles is still a leading cause of death for young children.

The Measles Initiative, launched in 2001, is focusing on four key strategies: providing one dose of measles vaccine to all infants via routine health services; a second opportunity for measles immunisation for all children, generally through mass vaccination campaigns; effective surveillance for measles; and enhanced care, including the provision of supplemental vitamin A. As a result of these measures, measles immunisation coverage with the first routine dose increased from 71 to 77% globally between 1999 and 2005, and over 360 million children aged between nine months and 15 years received measles vaccines through immunisation campaigns. The largest percentage reduction in estimated measles mortality between 1999 and 2005 was in the western Pacific region (81%), followed by Africa (75%) and the eastern Mediterranean region (62%). Africa achieved the largest total reduction; 72% of the global reduction in measles mortality. Nearly 7.5 million deaths from measles were prevented through immunisation in this period, with the Measles Initiative’s activities and improved routine immunisation accounting for 2.3 million of these prevented deaths.

The Measles Initiative has now set a new target: to cut measles deaths to 90% of the level they were in 2000 by 2010, primarily through ensuring children receive a second dose of measles vaccine shortly after the first. In 2005, the WHO Regional Office for Europe targeted measles for elimination from the then 52 member states of the WHO European Region by 2010. Over 29 000 measles cases from the region were reported to the WHO in 2004, and the WHO has estimated that 4850 measles deaths may have occurred in the region in 2003 [4]. The Measles Initiative will now target India, Indonesia, Pakistan and other large countries who have yet to increase routine coverage and address susceptible adults through mass vaccination campaigns more aggressively, in the hope of making further progress in the worldwide target of mortality reduction.

*Erratum. The original title stated that measles eradication was on target, whereas in fact, elimination, not eradication was meant. Corrected 26 January 2007 by the editorial team.