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WHO events addressing public health priorities

Citation: World Health Organization. Regional meeting on the implementation of Articles 9 and 10 of the WHO Framework Convention on Tobacco Control. East Mediterr Health J. 2023;29(9):758–759. https://doi.org/10.26719/2023.29.9.758

Copyright © Authors 2023; Licensee: World Health Organization. EMHJ is an open access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo .

¹https://applications.emro.who.int/docs/WHOEMEPI362E-eng.pdf 

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Introduction

In 2015, the WHO Regional Committee for the Eastern Mediterranean endorsed the Eastern Mediterranean Vaccine Action Plan 2016–2020 (1). The plan provides guidelines for the verification of elimination of measles and rubella and set targets for the control of indigenous measles virus transmission. In February 2018, WHO/EMRO established the Regional Verification Commission for Measles and Rubella Elimination (RVC-MR) and in November 2022 the commission held its fourth meeting to review progress in the elimination of measles and rubella in the region (2).

Summary of discussions

Some of the challenges hindering the achievement of the measles and rubella elimination targets in the EMR are insecurity, humanitarian emergencies, inadequate visibility of measles elimination among decision-makers, competing priorities, weaknesses in the immunization systems of some Member States, low demand, insufficient funding for supplementary immunization activities, limited donor funding, and high staff turnover due to brain-drain of qualified professionals.

Based on verification conducted in 2018–2020 (3), Bahrain continues to sustain the elimination of measles and rubella, although there were a few sporadic cases in 2018 and 2019 with no transmission chain of more than 12 months.

Islamic Republic of Iran has demonstrated strong political commitment to sustaining the elimination measles and rubella following verification in 2018–2020 (3). Its Expanded Programme on Immunization (EPI) developed a measles and rubella strategic plan and an outbreak preparedness and response plan that will allow the country to prevent and respond to any risk of cross-border transmission.

Despite the COVID-19 pandemic, EPI services have continued in Oman, including defaulter tracing and sustained vaccine supply. The country has sustained its measles and rubella elimination status following the 2018–2020 verification (3).

Based on the 2018–2021 verification, Egypt has eliminated measles and rubella and their endemic transmission. The country developed and is implementing a multiyear national strategic plan for the elimination of measles and rubella and has allocated funds for the activities. It is currently addressing issues related to the vaccination registration system, unregistered children, nomadic populations, genotype sequencing, and reporting mechanisms for the private sector.

Recommendations

To improve on progress made so far, there is a need to financially support countries that are close to elimination of measles and rubella.

For WHO

Support the establishment of regional targets for measles and rubella elimination linked to Immunization Agenda 2030.

Strengthen EPI programme management for the achievement of the measles and rubella elimination targets in high-priority countries.

Conduct outbreak simulation exercises and support countries in developing or updating their preparedness and response plans.

Support programmatic capacity-building at the regional and country levels on measles and rubella elimination.

For Member States

Strengthen cross-border collaborations and coordination on the elimination of measles and rubella.

Strengthen and sustain national immunization programmes and vaccine-preventable disease surveillance systems, including capacity-building for case investigation.

Strengthen internal coordination with epidemiological departments for the integration of vaccine-preventable disease surveillance.

Engage in the measles and rubella elimination verification process and submit annual reports to RVC-MR.

Countries with cases of double infection of measles and rubella should conduct further IgM analyses and case investigations to distinguish the true double infection from a reagent issue or other causes.

To the RVC-MR secretariat

Focus technical support on countries close to elimination of measles and rubella and document elimination status while building the capacity of national verification committees and secretariats.

Sustain vaccine supplies in conflict-prone countries.

References

1. World Health Organization. Eastern Mediterranean Vaccine Action Plan 2016–2020: A framework for implementation of the Global Vaccine Action Plan. Cairo: WHO Regional Office for the Eastern Mediterranean, 2019. https://applications.emro.who.int/docs/EMROPUB_2019_EN_22331.pdf.
2. World Health Organization. Summary report on the fourth meeting of the Regional Verification Commission for Measles and Rubella Elimination in the Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean, 2023. https://applications.emro.who.int/docs/WHOEMEPI362E-eng.pdf?ua=1.
3. Teleb N, Atta H, Hajjeh R. Measles and rubella elimination in the Eastern Mediterranean Region: successes and challenges. East Mediterr Health J. 2019;25(10):667–668. https://doi.org/10.26719/2019.25.10.667.