Emory Vaccine Center, Emory University School of Medicine, Emory University, 1462 Clifton Road NE, Suite 446, Atlanta, GA 30322, USA.
2650 Bowker Avenue, Victoria, Canada.
Vaccine. 2018 Jan 11;36 Suppl 1:A35-A42. doi: 10.1016/j.vaccine.2017.10.065.
Measles, a vaccine-preventable illness, is one of the most infectious diseases known to man. In 2015, an estimated 134,200 measles deaths occurred globally. Rubella, also vaccine-preventable, is a concern because infection during pregnancy can result in congenital defects in the baby. More than 100,000 babies with congenital rubella syndrome were estimated to have been born globally in 2010. Eradication of both measles and rubella is considered to be feasible, beneficial, and more cost-effective than high-level control. All six World Health Organization (WHO) regions have measles elimination goals by 2020 and two have rubella elimination goals by that year. However, the World Health Assembly has not endorsed a global eradication goal for either disease. In 2012, the Measles and Rubella Initiative published a Global Measles and Rubella Strategic Plan, 2012-2020, referred to hereafter as the Plan, which aimed to achieve measles and rubella elimination in at least five WHO regions by end-2020 through the implementation of five core strategies, with progress evaluated against 2015 milestones. When, by end-2015, none of these milestones had been met, WHO's Strategic Advisory Group of Experts on Immunization (SAGE) recommended a mid-term review of the Plan to evaluate progress toward goals, assess the quality of strategy implementation, and formulate lessons learned. A five-member team reviewed documents and conducted interviews with stakeholders as the basis for the review's conclusions and recommendations. This team concluded that, although significant progress in measles elimination had been made, progress had slowed. It recommended that countries continue to work toward elimination goals with a focus on strengthening ongoing immunization systems. In addition, it concluded that the strategies articulated in the Plan were sound, however full implementation had been impeded by inadequate country ownership and global political will, reflected in inadequate resources. Detailed recommendations for each of the Plan's five strategies as well as the areas of polio transition, governance and resource mobilization are outlined.
麻疹是一种可通过疫苗预防的疾病，是已知的最具传染性的疾病之一。2015 年，全球估计有 13.42 万人死于麻疹。风疹也是可通过疫苗预防的疾病，令人担忧的是，孕妇感染风疹可能导致婴儿先天缺陷。据估计，2010 年全球有超过 10 万名先天性风疹综合征婴儿出生。消除麻疹和风疹都被认为是可行的、有益的，而且比高水平控制更具成本效益。所有六个世界卫生组织（世卫组织）区域都制定了到 2020 年消除麻疹的目标，其中两个区域到该年消除风疹。然而，世界卫生大会尚未核准这两种疾病的全球消除目标。2012 年，麻疹和风疹倡议发布了《2012-2020 年全球麻疹和风疹战略计划》（以下简称《计划》），该计划旨在通过实施五项核心战略，到 2020 年底在至少五个世卫组织区域实现消除麻疹和风疹的目标，该计划的实施进展情况将根据 2015 年的里程碑进行评估。到 2015 年底，这些里程碑无一实现，世卫组织免疫战略咨询专家组（免疫咨询专家组）建议对该计划进行中期审查，以评估实现目标的进展情况、评估战略实施的质量，并总结经验教训。一个由五名成员组成的小组审查了文件，并与利益攸关方进行了访谈，作为审查结论和建议的依据。该小组的结论是，尽管在消除麻疹方面取得了重大进展，但进展已经放缓。该小组建议各国继续努力实现消除目标，重点是加强正在进行的免疫接种系统。此外，该小组的结论是，该计划中阐述的战略是合理的，然而，由于国家自主权和全球政治意愿不足，反映在资源不足方面，全面实施受到了阻碍。详细建议包括《计划》的五项战略以及脊灰炎过渡、治理和资源调动等领域。
