Why in News?

• Over 3,000 people have been killed by a deadly Measles virus in DR Congo this year

What is measles

• Measles is a highly contagious viral disease.
• It remains an important cause of death among young children globally, despite the availability of a safe and effective vaccine.
• Measles is transmitted via droplets from the nose, mouth or throat of infected persons. Initial symptoms, which usually appear 10–12 days after infection, include high fever, a runny nose, bloodshot eyes, and tiny white spots on the inside of the mouth. Several days later, a rash develops, starting on the face and upper neck and gradually spreading downwards.
• Measles poses less of a threat globally and specifically to wealthy countries, as vaccination programmes are widespread and effective.
• Even countries with well-developed healthcare systems would struggle to contain an Ebola outbreak, while a measles outbreak in a country with widespread immunity would have far less social, medical and economic impact.

Background:

• Ebola outbreaks, such as the current one in the Democratic Republic of the Congo (DRC), which has claimed2,074 people’s lives, are widely covered in the media.
• Although measles has a much lower mortality rate than Ebola, there have been over165,000 suspected cases of measles, with over 3,200 deaths in the DRC since the start of 2019.

Vaccination:

• For a vaccination programme to be effective, at least 92-95 per cent of the population must be immunised — this creates so-calledherd immunity.
• Another approach is ring vaccination.
• Ring Vaccination
• This is where clusters of people who are particularly at risk are vaccinated.
• This approach can help to contain the spread of an outbreak, but with aid organisations facing attacks, community mistrust and under-resourcing, even ring vaccination approaches are proving difficult to implement in both outbreaks.
• Herd Immunity
  • Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, thereby providing a measure of protection for individuals who are not immune.

Countries that Eliminated Measles:

• Five countries have eliminated measles – Bhutan, DPR Korea, Maldives, Sri Lanka and Timor-Leste.

Issue in Congo:

• Many local communities in the DRC mistrust medical workers. It stems from years of regional isolation andconflict.
• In some areas, this mistrust has even led to violence against the “wealthy” and “foreign” humanitarian aid workers, resulting in treatment centres being closed and thecontainment response being stalled for both Ebola and measles.
• The perception that the international response to measles is minimal compared with the effort mounted against Ebola also stirs mistrust and anger within the DRC.

WHO on Measles:

• World Health Organisation (WHO) declared the current Ebola outbreak a public health emergency of international concern, partly in response to international pressure and fear of the disease spreading to other countries. Measles has been given no such status.
• The WHO has raised almost $114 million for combating the DRC Ebola outbreak, while barely $2.5 millionhas been raised to combat measles.
• Why WHO must focus on Measles
  • This is especially relevant when considering that an aspect of public resistance stems from the response teams only treating Ebola, whereas, from a community perspective, diseases such as measles and malaria are far greater threats to their lives.
  • For example, malaria was responsible for over27,000 deaths in the DRC in 2017.
• How then should the international community respond to outbreaks to protect both the overall health of a community and the global spread of a specific disease?
  • Solution is as recently proposed byDoctors Without Borders and The Alliance for International Medical Action.
  • They suggested that instead of the international community delivering targeted aid for only Ebola, resources should be deployed to strengthen local infrastructure and provide a decentralised capacity to provide care to all communities.
  • This may enable a country to contain an Ebola outbreak while still responding to outbreaks of other infectious and non-infectious diseases, providing better care for local communities.
  • By using international resources to strengthen local infrastructure, it might be possible to create more resilient community health systems capable of responding to future outbreaks, possibly without needing international support.