Challenges of Measles Control and Elimination in Resource Poor Settings

The spectacular success of the Pan American Health Organization (PAHO) in eliminating measles from the Americas might suggest that simply exporting the strategies PAHO deployed worldwide should result in global elimination of this potentially fatal infection. However, in areas where measles remains endemic, access to care is highly variable, as are the demographic rates (birth, movement), which underlie the spread of the infection. Combined, these features mean that targeting control efforts for maximum efficiacy become essential. Evaluation of such targeted interventions is key to establishing both what has worked and what hasn't; as well as where future vulnerabilities lie. Statistical and mathematical methods based on data from case surveillance, serology and coverage can all contribute to contribute to this goal.