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GAVI to use Vaccine Fund resources to support measles mortality reduction in Africa

Measles is the leading cause of vaccine-preventable mortality of children, killing more than 500,000 children every year, according to estimates.

In countries with low vaccination coverage, it is essential to protect the susceptible population as quickly as possible. This is most effectively done through what are known as "catch-up" campaigns which generally target children 9 months through 14 years of age.

However, due to the highly infectious nature of measles, the fact that 10-20% of 9 month olds will not be protected by the vaccine, and the relatively low coverage currently in the poorest countries for the first dose, it is essential to provide as many children as possible with an opportunity for a second dose of measles vaccine.

Almost all industrialized countries and many middle income countries have adopted two-dose strategies in their routine immunization systems. The poorest countries have not.

Therefore in many of the poorest countries, "follow-up" campaigns are used to reach children with the second dose of measles vaccine, generally targeting children between 1 and 4 years of age.

Once the routine system for delivering vaccine is sufficiently robust, the need for and cost of campaigns can largely be replaced by providing the second dose of vaccine to children between 12 and 18 months of age year through routine immunization services.

In November 2002 the GAVI Board endorsed the WHO/UNICEF joint strategy for measles mortality reduction, which includes the above principles.

The GAVI Board has now decided to use Vaccine Fund resources to in two ways - $37 million to support "catch-up" campaigns in low-coverage countries that have not yet implemented these campaigns, and $13 million to support provision of a routine second dose of measles vaccine in high performing countries. The UN Foundation will provide an additional $9.25 million matching grant.

Countries eligible for resources for catch-up campaigns (Central African Republic, Chad, Democratic Republic of Congo, Djibouti, Mozambique, Nigeria, Niger, Sudan, Somalia and Republic of Congo)will access the funds through the African Measles Partnership.

Higher performing countries in Africa (specific countries still to be determined) will be eligible for resources for routine second measles dose; they will access the funds through GAVI/Vaccine Fund country application mechanism.

It is estimated that GAVI/Vaccine Fund support will result in a massive impact on measles mortality; approximately 1.84 million children's lives will be saved by the project over the period 2005 through 2009.

More information on how to access the funds will be available here on the website as soon as possible.

Resources and information

Download the full Measles Investment Case (pdf 570Kb), submitted to the GAVI Board in April 2004 and approved, with the addition of an addendum, in July 2004.

GAVI Board Statement of support for measles mortality reduction, November 2002

"Measles meets its match", Immunization Focus, October 2003

"Coming to grips with the big one", Immunization Focus, November 2000

Website of the Africa Measles Initiative

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