Africa-Press – Eritrea. Measles cases are spiking globally. According to UNICEF, an agency of the United Nations dedicated to promoting the rights and well-being of children worldwide, over the past five years, measles outbreaks have hit over 100 countries, home to roughly three-quarters of the world’s children. (Some of the countries hit had previously eliminated measles altogether.)
Although vaccines are a safe, cost-effective, proven way to prevent children from contracting measles and spreading the disease to others, too many children around the world are still unprotected. Currently, the global coverage rate for measles vaccination, which is safe and provides 99 percent protection for life, is far below the level needed for robust protection, ultimately leaving ample room for measles to spread and putting vulnerable groups, including unvaccinated children, at higher risk.
Despite various challenges, Eritrea has made significant strides in addressing measles over the years. The following article explores Eritrea’s general progress and efforts to combat the disease and protect its children.
A snapshot of Eritrea’s progress
Caused by a virus, measles is a highly transmissible, severe disease that usually results in a high fever and rash but can also lead to blindness, encephalitis, or death. The disease remains one of the leading causes of death among young children globally, especially in the developing world (particularly in parts of Africa and Asia). Currently, however, outbreaks are happening in every region of the world.
The measles vaccine, first made available nearly 60 years ago, has proven to be an extremely safe, highly efficacious, and inexpensive way to reduce measles incidence and mortality in many parts of the world. While the measles vaccine is available in monovalent formulation, it is commonly incorporated with other vaccines, thus allowing for shared delivery and administration costs. It is equally effective in the single or combined form.
Over the years, Eritrea has maintained high coverage for measles vaccination, making substantial progress toward measles elimination. (While Eritrea has made significant strides in moving towards measles elimination, it still must complete several steps to achieve formal certification of complete elimination.)
For many years, children in Eritrea were provided one dose of the measles vaccine at around nine to 12 months of age. However, in 2009, the World Health Organization (WHO) recommended that reaching all children with two doses of measles vaccine should be the standard for all national vaccination programs, to decrease incidence and mortality from measles further and progress toward elimination. Two doses help ensure immunity and prevent outbreaks, as many vaccinated children, perhaps up to approximately 15 percent, may fail to develop immunity after receiving the first dose.
In 2012, not long after the WHO’s global recommendations, Eritrea introduced a second dose of the measles vaccine into the national routine vaccination schedule. Since 2018, Eritrean children have received two doses of the combined measles-rubella vaccine. In 2023, measles vaccine coverage for the first and second doses was 93 percent and 85 percent, respectively, considerably higher than the continental and global averages. Notably, the coverage for the first dose is well above what it was in 2000 – 76 percent – and nearly three times more than the figure in 1993, when it was about 34 percent.
In terms of incidence, in 2023, there were 54 reported measles cases nationwide, with an incidence rate of about 15.6 per 1,000,000 total population, reflecting continued progress on prevention and control. By comparison, Africa (per the WHO’s regional categorization) had more than 424,000 cases, with an average incidence rate of about 195 per 1,000,000 total population.
Success is part and parcel of broader health-related efforts
Eritrea’s sustained success against measles is part and parcel of the country’s broader, award-winning national routine childhood vaccination program. Routine childhood vaccination is a significant health intervention that helps prevent serious illness, disability, and death in children caused by a range of dangerous diseases. Beyond measles, these include diphtheria, tetanus, pertussis (whooping cough), influenza, pneumonia, and rubella.
Since winning its independence, Eritrea has made tremendous leaps in routine vaccine coverage. In 1991, only six vaccines were available for children, and the overall coverage rate stood at less than ten percent. (Some of the vaccines provided at independence included the Bacille Calmette-Guérin vaccine and the vaccines for diphtheria, tetanus, and pertussis, among others.) Over subsequent years, however, the national routine vaccination schedule in Eritrea steadily grew, and it has progressed to provide young children with an array of vaccines that help protect against various serious or potentially fatal diseases.
At present, Eritrea administers a total of 14 vaccines to young children. These protect against several dozen diseases; overall coverage rates are above 90 percent. Through the Ministry of Health and the National Immunization Programme, around 300 health facilities provide free routine vaccination services six days per week. In addition, vaccination service is provided at about 450 outreach sites nationwide, while nomadic groups and those residing in extremely remote or difficult to reach areas receive service through mobile health units, barefoot doctors, and mass vaccination campaigns organized in close cooperation with community coordinators, volunteers, and local contacts.
Notably, regional and global organizations have recognized and celebrated Eritrea’s progress. For example, in November 2009, Eritrea garnered recognition from Gavi, a public-private global health partnership, for its outstanding performance in improving child health and immunization. One of 17 countries to be recognized at the Vietnam ceremony, Eritrea won the “Best Immunization Performance” award. In 2016 and 2017, Eritrea received back-to-back awards from UNICEF’s Eastern and Southern Africa Regional Office for effective vaccine management practices, while in September 2018, the country received another prize from UNICEF in recognition of improvements in its national vaccine store.
Additionally, during a working visit to Eritrea in late 2021, Mohammed Malick Fall, UNICEF Regional Director for East and Southern Africa, explained that he was, “struck by the level of immunization [of children],” before going on to note that there, “are many advanced countries that have a hard time reaching [those coverage levels].”
A strong commitment to children – the nation’s most valuable resource
Another critical element surrounding Eritrea’s success in the fight against measles is how it reflects the nation’s unwavering commitment to its most valuable resource – children.
One of the world’s youngest countries, Eritrea possesses a rich history, a blend of beautiful cultures, and vibrant diversity. Blessed with a warm, hospitable climate, it has a long, pristine shoreline on the Red Sea, a constellation of islands, an abundance of marine and natural resources, incredible wildlife and biodiversity, and significant agricultural potential. The country is also positioned along one of the world’s most important international maritime shipping routes and boasts endless possibilities for a thriving tourism sector. Despite all these advantages, Eritrea’s greatest asset and most important resource, by far, is its valiant people, especially its youth.
As a powerful reflection of this, across the three decades since winning its independence, Eritrea has maintained a strong, unwavering commitment to its youth’s health, well-being, and development. The UN’s Convention on the Rights of the Child was the first international convention ratified by the Eritrean government after the nation won its independence. At the same time, it also acceded to the African Charter on the Rights and Welfare of the Child in December 1999, not long after the Charter entered into force.
The Eritrean National Charter, adopted in Nakfa in February 1994, and which provides the guiding vision for the country, clearly articulates the prioritization of children. Specifically, it firmly declares, “Eritrea should strive to minimize infant mortality and to care for its children. The children of martyrs, in the tens of thousands, who were deprived of the love of their parents, as well as other orphans, must be provided with proper upbringing and care. In Eritrea, children’s rights to education, health, love, safety, play, and human dignity must be respected.”
Eritrea’s high rates of measles vaccination and impressive figures from the national vaccination campaign are thus only a continuation of the country’s longstanding and strong commitment to its people and prioritization of its youth.
Conclusion
In conclusion, Eritrea’s efforts in combating measles reflect the country’s commitment to improving child health through strong vaccination programs. With high vaccination coverage and consistent progress in reducing measles cases, Eritrea is a model for other nations in the region. These achievements highlight the importance of prioritizing public health to protect vulnerable populations, especially children.
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