Paving the way for eliminating measles and rubella in the Pacific by 2025

Measles is one of the world’s most contagious diseases and spreads quickly in unvaccinated communities. Even though a safe and cost-effective vaccine is available, in 2023, there were an estimated 107,500 measles deaths globally, mostly among children under the age of 5 years. The virus that causes measles weakens the immune system leading to severe illness, complications and even death. Children who develop severe complications can be left with disabilities after their recovery.

In 2019, the Pacific faced significant measles outbreaks, which taught invaluable lessons and helped countries improve their preparedness to tackle any future outbreaks. Combining decades of lessons learned and efforts to expand immunization programmes, countries are more vigilant and better equipped to handle such threats.

Like measles, rubella is another highly contagious disease and is the leading cause of birth defects worldwide—another disease that can be prevented by vaccines. Getting rubella whilst pregnant can lead to miscarriage or babies born with disabilities such as hearing impairments, eye, and heart issues. Globally, every year approximately 100,000 babies are born with disabilities due to rubella. Even though a safe and cost-effective vaccine is available, in 2022, there were an estimated 17,865 cases of rubella in 78 countries.

The Pacific is on track to eliminate these diseases by 2025. Since early 2020, there has been no ongoing transmission of measles and rubella, thanks to stronger immunization programmes or in catch-up campaigns focused on individuals who missed vaccinations or are behind on their immunization schedules.

Despite these achievements, challenges remain. The Pacific Immunization Managers Meeting held in Fiji from 25-29 November, provided a chance for managers and partners to come together to share their experiences and lessons learned.

Delivering the opening speech, Dr Jemesa Tudravu the Permanent Secretary for Health and Medical Services emphasized that “the meeting provides a platform for Pacific-driven dialogue and problem-solving to strengthen immunization systems, increase vaccination coverage, and enhance disease surveillance. Together, we aim to tackle vaccine hesitancy, improve supply chain efficiency, and ensure preparedness for potential outbreaks.”

Co-creating future priorities to march towards elimination

During the immunization managers meeting, each PIC identified priority actions to reach the target of measles and rubella elimination in 2025. The work does not stop after eliminating a disease—it requires ongoing commitment to maintain elimination status. In efforts to foster collaboration and exchange best practices, including across various regions, the Pan American Health Organization (PAHO) and WHO Caribbean Member States joined the meeting to share their experiences as small island developing states in disease control, elimination, and sustaining such status. Their insights highlighted the importance of sustaining elimination efforts through policy, governance, health financing, community engagement, building trust, and resilient health systems.

Health care workers: heroes of immunization successes

During the meeting, the participants also emphasized the hard work of various health care workers, which greatly contribute to the successes of increasing the number of people vaccinated against diseases like measles and rubella. Among others, these are nurses, community health workers and other health care personnel at health care facilities and nursing stations, who do not only deliver immunizations but also engage communities and raise awareness, often reaching remote and underserved areas.

Catch-up campaigns and efforts to immunize communities are critical to sustaining elimination goals. Strengthening areas like laboratory capacity is equally important for robust disease surveillance, ensuring timely testing and sample processing. Despite logistical and financial challenges, immunization teams across the Pacific consistently demonstrate extraordinary commitment. Their hard work and devotion to public health ensures that sick children and adults are cared for, important tests are done, people understand the risk of vaccine-preventable diseases, and vaccines are offered to all including to those most at-risk or living rurally.