WHO and measles

Reading the comments here can be both exhilarating and dismaying. The peevishness I see about WHO falls into the dismaying category. People who follow bird flu have a tendency to get crotchety with WHO over some of its more flagrant gaffes and obvious attempts at spinning, although which way the spin goes isn't always clear. But WHO does a lot with a little, a budget less than that of some major American hospitals. We've been (we think appropriately) critical of WHO here, but it is an agency that also has done, and continues to do, a powerful amount of good in this world. The recent announcement about the battle against measles is a case in point:

An international vaccination programme to combat measles has exceeded targets, reducing child deaths from the disease by 60% between 1999 and 2005.

The international Measles Initiative launched in 2000 by the World Health Organization and UNICEF had aimed for a 50% reduction in 45 target countries.

"Deaths have fallen from 873,000 during 1999 to 345,000 by the end of 2005," said WHO director-general Margaret Chan, on Thursday. "This is a 60% reduction." And the news is even better in Africa, Chan said. "Deaths there declined by 75%, so Africa is leading the way."

Measles deaths in children under five fell from 791,000 to 311,000 over the same period, globally.

The new figures estimate that, altogether, measles vaccinations have prevented 7.5 million deaths between 1999 and 2005, and 2.3 million of these were attributable to the intensified programme. "This is tremendous news for the world's children," said Ann Veneman, executive director of UNICEF. (New Scientist)

Measles is thought of as a nuisance childhood disease in the US and Europe (although it has largely disappeared in both places because of measles vaccine, providing the vaccine is used, of course), but in the developing world it was a major killer, as these figures note. WHO was the engine behind the dramatic drop in measles deaths

There's more to do. Ambitious plans for a ten fold reduction are on the drawing boards. But the gains so far are not just impressive. They have saved the lives of almost a half a million children in 6 years.

No one is helped by blanket condemnations of WHO. This achievement shows that WHO is not a useless organization. If it did nothing else but save those children it would have done more than most governments with orders of magnitude more resources. But it has done more, in polio, malaria, population control and much else. That's why we hold it to a high standard regarding bird flu, too.

We will continue to criticize WHO when we feel it is warranted. But today is a day to recognize an achievement they can be proud of.

More like this

Good point. On many fronts, WHO is to be lauded. (Although, if I'm reading it right, WHO is saving almost half a million children under five from measles per year, and 2.3 million children in six years. Which is even more impressive.)

Your comments revere are reflective of the fact that mankind does stand a chance in this sometimes frightful world. Behind the WHO organization are people, just like you and me, who truly do care and consider their actions and the impact on society stemming from those actions.

As a child the measles attacked me with a vengeance. It is interesting that I survived. Even at that young age though there was an innate desire to survive and it was strong enough to get me through it.
It was a dark room that I laid in for over a week, barely able to move and the hallucinations were numerous. One of the hallucinations was of being on a conveyor belt and being the medicine bottle; there were four belts that came together in the center and at that center the bottle would crash. The bottle always recovered and continued the same thing over and over.
Also a great feeling of being crushed in the chest area by a huge ball of energy where at the last moment of being able to tolerate it, the weight lifted.
Near the end of this experience the hallucinations lightened up and were tolerable, if that makes sense.
These were also the days of doctors making house calls. What a remarkable doctor too, Dr. Blount.

Lea, I'm trying to figure out how to get my neighbor to read your description of measles. Maybe she'd finally get her kids vaccinated.

Susan: It was a horrible experience. The sickness was so strong, so very strong.

Yeah, a common problem for UN agencies in general. We deny them funds, then complain when they fail to achieve miracles. We refuse to give them any real power, then complain that they're powerless.

Poor bastards.

Not saints, of course. Idiocy is still idiocy no matter how good the intentions, and that should be exposed, but too many people are harder on them than they deserve.

By SmellyTerror (not verified) on 20 Jan 2007 #permalink

Whilst I sympathize with Lea and her experience of measles, I've nursed a 21 year old man who died of measles in Prince Henry Hospital in Sydney in the 1970's. In adults. measles is far more fatal than it is as a childhood disease.

In 1860, measles arrived in Albany, Western Australia, on board a ship called the 'Salsette' and decimated the local Noongar(Aboriginal) population. A series of measles outbreaks over the next 20 years had a significant affect on the Noongar population of the South West. Elsewhere in Australia, smallpox had taken a similar toll. The south west was spared because vaccination against small pox had been introduced before the 1830's when the area was colonized.

My concern is that the rush to vaccinate against measles in particular has not AFAIK(!) considered the implications of outbreaks of measles. We already experience outbreaks of whooping cough due to non-compliance with existing vaccination routines - but the infectivity and target susceptibility is quite different for each disease.

I do support vaccination but I'm concerned that communities can start to question the value of vaccines for all known diseases and become resistant to public health messages. They do have a cost in terms of time, money and pain for individuals as well as the government.

Kyan-Yeah and even I would say that anyone who doesnt get their children and themselves vaccinated do so with only themselves in mind and not the next guy and his/her family. That being the case then if everyone else is vaccinated then most of the time only the dumbass's of the world get it. Natural selection of the brightest dummies by God or Nature for elimination. I had never seen scarlet fever until central america in the early 80's. Whoa, now thats ugly. Fortunately a church group ponied up in the US and we vaccinated everyone. I think they lost 20 in a very horrific way... Survivors mentioned the hallucinations but I thought those were from fever and not the actual bug. One guy I saw was covered and looked like a big pus wad of sores. Ran right down and checked the shot record card on file for me. But I had measles when I was a kid so supposedly no need for vaccine.

By M. Randolph Kruger (not verified) on 20 Jan 2007 #permalink

Sorry to be a wet blanket at the party, but:

Half a million lives saved per year, half a billion in ten years, and 6.5 billion humans on a planet that can at most support 2 - 3 billion sustainably.

So: how many lives saved now? How many people condemned to famine later.

I would be more optimistic if someone was providing statistics on births prevented per year via contraception and family planning. That's the number to watch in terms of saving us from the excesses of our own apparently terminal stupidity.

g510: do you consider death-by-preventable-disease an acceptable form of population control?

As per the second half of your post, preveting births in the first place is the only ethical method. Once they're here then YES, saving kids' lives is a good thing.

...and WHO does support birth control through education and allocated resources. Again, they do not have remotely the funding to create miracles. I'm not sure what you're suggesting they do.

By SmellyTerror (not verified) on 20 Jan 2007 #permalink

g510: More importantly, birth rates decline when childhood mortality declines. One reason birth rates are so high in developing countries is that death rates for children are high. Children are a form of social security (they are labor for the family and support the parents as they get old). It is a general phenomenon that birth rates decline as mortality declines and vice versa. So morality aside, it is a humane and effective form of birth control to improve the health of children.

All the goodness in the world does not replace the incapacity to understand and speak truthfully.

Or did I miss the point?

Is an H5N1 CFR of 40, 6, 75, 100% to be considered one of WHO's mistakes that is balanced by their measles efforts?

There are specific individuals who have failed and continue to fail.. to speak truthfully, to disclose the facts, to, if I may be so presumptuous, think proactively and state the range of risk as it appears in the then present moment. Are we to stay blind to this?

By Gaudia Ray (not verified) on 21 Jan 2007 #permalink

GR: Yes, you missed the point. WHO is not a person. It is an organization. It makes mistakes (even if you don't), but it does an enormous amount of good in this world (even if you don't). Their H5N1 performance has been uneven (even if yours hasn't), but they are the only game in town (even if you aren't), so we should give them credit for what they accomplish (even if you don't) and cricized them constructively for what they can do better (even if you don't).

In an effort to improve health care here at home, one of our esteemed state reps, who always emphasizes that he is a practicing physician, is filing a bill to ban any state funding for vaccines made from stem cell lines from aborted fetesus, even those from the 1960's.Of course, those are not important vaccines. The following list comes from the Children of God for Life website: COGFL Disease: Product Name
Chickenpox/Varicella: Varivax
Hepatitis A: Vaqta, Havrix
Hepatitis A & B: Twinrix
Measles, Mumps, Rubella: MMR II
Measles-Rubella: MR VAX
Mumps-Rubella: Biavax II
Rubella: Meruvax II
MMR + Chickenpox/Varicella: ProQuad
Polio: Poliovax
Rabies: Imovax
Rheumatoid/OsteoArthritis: Enbrel
Sepsis: Xigris
Shingles: Zostavax
Under Development Ebola: TBA
Under Development Flu: TBA
Avian Flu: TBA
New: HIV: TBA
New: Smallpox: Acambis 1000
I tried to post a link to the Newspaper article, but it is a subscription only site. A brief perusal of the CoG website listed above will give a flavor of his inane arguement.

By Man of Misery (not verified) on 21 Jan 2007 #permalink