Assessment of the 2010 global measles mortality reduction goal: Results from a model of surveillance data

Background: In 2008 all WHO member states endorsed a target of 90 reduction in measles mortality by 2010 over 2000 levels. We developed a model to estimate progress made towards this goal. Methods: We constructed a state-space model with population and immunisation coverage estimates and reported surveillance data to estimate annual national measles cases, distributed across age classes. We estimated deaths by applying age-specific and country-specific case-fatality ratios to estimated cases in each age-country class. Findings: Estimated global measles mortality decreased 74 from 535 300 deaths (95 CI 347 200-976 400) in 2000 to 139 300 (71 200-447 800) in 2010. Measles mortality was reduced by more than three-quarters in all WHO regions except the WHO southeast Asia region. India accounted for 47 of estimated measles mortality in 2010, and the WHO African region accounted for 36. Interpretation: Despite rapid progress in measles control from 2000 to 2007, delayed implementation of accelerated disease control in India and continued outbreaks in Africa stalled momentum towards the 2010 global measles mortality reduction goal. Intensified control measures and renewed political and financial commitment are needed to achieve mortality reduction targets and lay the foundation for future global eradication of measles. Funding: US Centers for Disease Control and Prevention (PMS 5U66/IP000161).