Measles incidence increases worldwide

Measles cases increase by 300% worldwide, spurred on by anti-vaccination campaigns, supply chain issues and conflict. 

Background

A vaccine is a biological concoction that provides acquired immunity to a particular disease. It does this by through an agent that resembles a disease-causing microorganism and is often made of a form of the microbe itself. They have contributed to reducing the spread of common childhood diseases, some of which have been completely eradicated like Smallpox and Rinderpest. 

Measles is a highly contagious, airborne disease. Once infected, the disease often results in death due to the lack of specific treatments. The measles vaccine has resulted in a 75% decrease in fatality, with about 85% of children inoculated by 2017. Primarily a childhood disease, measles affects about 20 million a year, particularly in Africa and Asia. Medical professionals believe that a two-dose vaccine can result in complete prevention.

Vaccine hesitancy or the anti-vaccination movement is the reluctance or refusal to be inoculated or to immunise one’s children. In 2019, the World Health Organization identified the movement as one of the top ten global health threats. The position contradicts irrefutable scientific consensus regarding the efficacy and safety of vaccines. Initially, the debates dealt with ethical and legal issues of individual agency and public health, although false information has recently tied vaccines to neurodevelopment disorders. This proliferation of false evidence has resulted in an increase in the number of anti-vaccination adherents. 

Analysis

The World Health Organization (WHO) recently stated, “Preliminary global data shows that reported cases rose by 300% in the first three months of 2019, compared to the same period in 2018. This follows consecutive increases over the past two years.” WHO added that despite the fact that the data was provisional, it indicates a sustained trend. Noting that only one in 10 measles cases are actually reported, WHO believes that the data is likely to underestimate the issue.

The issue is of particular concern as the increase in incidence is not localised to geographic regions where the population is largely unvaccinated. Instead, the spike has also occurred in countries with high overall vaccinations. Recently, the mayor of New York declared a public health emergency after a measles epidemic in an ultra-Orthodox Jewish community. This community is known for its distrust of modern science and is therefore vulnerable to anti-vaccination positions. The emergency imposed a policy where the community was either vaccinated or paid fines. 

Another driver of the increase in the outbreak includes vaccination supply problems, especially on the African continent. The continent produces less than 1% of all the vaccines, despite it being home to a vast majority of those unvaccinated. This is in spite of heavy subsidies and immunisation drives by African governments. Costs continue to make vaccinations unattainable for a sizeable portion of the population. Conflict adds to the number of individuals unable to secure vaccinations. However, conflict, lack of funds and supply problems are not the primary cause of the increase in measles cases in developed nations.

The anti-vaccination movement has led to serious concern about the spread of anti-vaccine misinformation. Although the movement is as old as vaccinations themselves, it has gathered significant steam in the internet age. The internet facilitates the spread of conspiracy theories and anti-pharmaceutical industry positions around the world. A slight dip in coverage can have significant ramifications: 95% inoculation rates are necessary to protect children who cannot be vaccinated because of compromised immune systems. Social media platforms, already afflicted by other misinformation issues, is the main culprit in the proliferation of vaccine hesitancy. GoFundMe, a crowdfunding platform, has banned campaigns that propagate the anti-vaccination position. Similar regulations are necessary across other social media outlets in order to stifle the spread of such misinformation. 

Another recourse available to authorities is through multilateral efforts aimed at instituting policies that make it difficult to not vaccinate one’s issue. Government laws necessitating vaccinations could prove effective and are ensuring high rates of inoculation at the domestic level. The UN could serve as an effective forum in ensuring global compliance by framing it as an issue of peace, stability and security through the lenses of public health.

Assessment

Our assessment is that there needs to be a concerted effort across the widest-cross section of society to negate the effects of anti-vaccination campaigns. As a communal platform, social media companies have a special responsibility in curbing the spread of vaccine-related misinformation. We believe that particular focus must be on geographic areas of reduced coverage, especially in Africa. It is our belief that countries must clamp-down at ports of entry, such as airports, in order to reduce the effects of those without inoculation; air travel allows such diseases to easily cross geopolitical borders. It is our view that the UN Security Council carries the most potent tool to stifle the spread of such diseases through a resolution on anti-vaccination framed against the backdrop of international security. 

India Watch

India must build on its successful polio eradication mission by improving its vaccination campaign against measles. More than a third of world measles deaths, before the recent global outbreak, occurred in India.

Image Courtesy - Russell Watkins / Department for International Development [CC BY 2.0 (https://creativecommons.org/licenses/by/2.0)]