I gave a lecture this afternoon to my undergraduate global health policy course at NYU (P11.0032 Global Health: Policies, Politics, and Institutions) in which we discussed progress towards the Millennium Development Goal 4 – a two thirds reduction in under five mortality from 1990-2015. I argued that one of the biggest sources of progress, and perhaps the one that is most easily attributable to a single intervention, were the declines seen in mortality from measles since the use of the measles vaccine become widespread.

A recent report by the CDC, reprinted in JAMA recently, provides the evidence to support such claims. Since 2000, it is estimated that deaths from measles have declined from about 733,000 deaths to 164,000 in 2008 – a whopping 78% decline in mortality in just 8 years. Success rates like that are relatively rare in global health. A recent paper by You and co-authors in the Lancet have estimated that child deaths declined from 10.4 to 8.8 million over the same time period, so roughly one third of the total declines seen over this time period can be attributed to this single intervention.

I was saddened to learn, however, that despite these successes, maintaining progress and sustaining this progress is at risk – so much so that the authors of the report even have estimated worst case scenarios of resurgence. Probably more so than most childhood vaccine preventable diseases really high sustained vaccination coverage is needed or else there is a significant risk of flare ups of the disease (this even happens in the US when parents forego vaccinating their children).

Measles vaccine funding has fallen off sharply in the past few years, and surprise surprise, national ministries of health are also having a hard time raising adequate funds. The Measles Initiative, one of the main funding agencies for measles vaccinations, has seen a decline in funding from about $150 million to $50 million. In the post-Global Fund/Gates Foundation/PEPFAR world, these levels of funding seem almost miniscule – in particular for such an amazing buy. Such a shame.

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