Lack of funding and vaccines challenge measles outbreak response in Sudan

5 April 2015 – The Ministry of Health of Sudan, in collaboration with the World Health Organization (WHO), UNICEF and other partners, continues to respond to the measles outbreak in affected areas.

More than 1600 suspected measles cases (with 710 confirmed) have been reported from 23 localities in 12 states of Sudan since the onset of the measles outbreak in December 2014. One of the most affected states is West Darfur, with most cases being reported among goldmine workers. Recently, new cases have been reported from North Darfur (Jabel Amer, Sharaf Omra) where the situation is compounded by internal displacement.

Since the onset of the outbreak, enormous efforts have been undertaken to control the outbreak, including conducting response immunization campaigns. Between 19 and 23 January, Gedarif and Kassala states of Sudan (where the outbreak first started) conducted a response measles immunization campaign in 11 localities targeting children from 6 months to 15 years. A total of 508 954 children were vaccinated during this campaign in Gedarif state (97.2% of targeted children), and 518 036 children were vaccinated in Kassala state (95% of targeted children).

Ongoing actions are being undertaken for the implementation of initial response and containment measures in West and North Darfur, including case management, alert investigation, response vaccination campaigns and community health awareness.

A WHO proposal to allocate US$ 3.9 million for response activities has been approved by the Measles and Rubella Initiative. These funds will enable implementation of the outbreak response in the 22 initially affected localities. The funds received will cover 50% of the requirements and the other 50% will be covered by the Ministry of Health. UNICEF will procure vaccines and other supplies, and WHO will provide operational and technical support.

To fill the gap for the remaining targeted 72 localities, UNICEF and WHO have submitted a Central Emergency Fund proposal for around US$ 4 million.

A campaign to cover all 22 affected localities and the additional 72 localities at high risk has been recommended.

Sudan is committed to the Global Measles and Rubella Elimination Strategic Plan 2012–2020. The strategies include: high vaccination coverage; monitoring of the spread of disease using laboratory-backed surveillance; outbreak preparedness and response and case management; communication and community engagement; and research and development.

However, timing is crucial to ensure the availability of the necessary financial and supplies for implementation of a one-phase comprehensive intervention, as population movement needs to be taken into account.

Other challenges include: vulnerabilities in insecure and hard-to-reach areas, ensuring a high quality implementation of the campaign and response intervention and limited vaccine availability – the country measles vaccine reserve after the distribution for routine activities is about 500 000 doses.

To address these challenges, the Ministry of Health, in collaboration with WHO and other partners, will strengthen pre-, intra- and post-campaign supervision along with monitoring and independent external evaluation to ensure effective implementation of campaigns.

To reduce the risk of rapid spread of the measles outbreak and the propagation of the wild virus across the whole country, WHO is working closely with the Ministry on raising population immunity combined with increased capacity for case-management and coordinating health sector members. To this effect, social mobilization and situation monitoring are urgently needed,” said Dr Naeema Al-Gasseer, WHO Representative in Sudan.