Once-rare measles outbreaks are returning to many African countries, where low vaccination coverage leaves many vulnerable.
About 44% of the world’s 2019 cases, as of September, were recorded in Africa – including a major outbreak in Madagascar with more than 150,000 cases and 1,000 deaths. In some places, health workers are in short supply and maintaining the cold chain is a challenge; elsewhere, vaccine misconceptions play a part.
In Uganda, a 2017 outbreak surprised health officials, given the country’s vaccine coverage – though that falls shy of reachaching herd immunity. Officials surmise many children got first doses but missed out on boosters.
Measles is having a deadly resurgence across Africa, where, as of September, about 44% of this year’s cases worldwide have been recorded. That’s due in large part to a massive outbreak in the island nation of Madagascar off the coast of Mozambique, where more than 150,000 cases have been reported and more than 1,000 people have died due to low vaccination rates and a vaccine shortage once the outbreak took hold.
In Uganda, vaccination rates are higher, but thinly stretched health budgets, mistrust of vaccines and complacency among people who think measles is a disease of the past have helped lead to the outbreaks.
“For the last 15, 20 years, medical students had never even seen measles,” said Dr. Edison Arwanire Mworozi, a pediatrician at Mulago who sits on the government’s immunization steering committee. “[People] never thought it would come back. They thought, ‘If my child is healthy, why should I inject him?’”