A Response to the Lancet

Ed Note:  Last week, The Lancet published an editorial and two studies about the current state of global health initiatives for the developing world.  The following is a response to The Lancet from Andrea Gay, Exeucitve Director of Children’s Health at the United Nations Foundation and Dr. Dan Carucci, Vice President for Global Health at the United Nations Foundation. 

While two studies in the Lancet medical journal on Friday, June 19, raised awareness about the importance of strengthening health systems worldwide and working with the United Nations to improve global health, it was shocking to see that the researchers failed to recognize the significance of the Measles Initiative, a model public private partnership that has produced real results.

Since 2001, the Measles Initiative has supported the vaccination of more than 600 million children in more than 60 countries. Between 2000 and 2007, the number of children dying from measles has decreased by 74% worldwide and nearly 90% in sub-Saharan Africa alone.

Launched in 2001, the Initiative—led by the American Red Cross, the United Nations Foundation, the U.S. Centers for Disease Control and Prevention, UNICEF and the World Health Organization—provides technical and financial support to governments for vaccination campaigns and case-based measles surveillance. National governments also provide funding, political support, and develop a detailed Plan of Action to implement the campaign and monitor the results. The process of preparing to conduct a campaign provides the opportunity for a country to strengthen its routine immunization system by improving planning, update training for health workers on injection safety, strengthen the cold chain, and improve waste management. One indication of this impact on immunization systems is the steady global increase in measles vaccine coverage since 2000. The global coverage exceeded 80% for the first time ever in 2007.

The Measles Initiative addresses health systems strengthening in a number of important ways through health working training, improved planning, strengthened infrastructure such as cold chain and medical waste management and up-to-date health policies such as the use of auto-disable syringes which prevents the spread of blood borne diseases such as HIV and hepatitis.

Bottom line is that the Measles Initiative is an obvious example of a disease specific global health initiative that stresses the importance of country-led planning, uses a clearly defined proven strategy on a global scale to prevent measles and which leaves behind stronger health systems overall. It is unfortunate that mention of the successes of the Measles Initiative were omitted by The Lancet editors.