Médecins Sans Frontières has launched a large-scale measles vaccination campaign in the West African nation of Guinea, amid fears that the Ebola outbreak of three years ago has left the country’s health care system weakened and vulnerable to other epidemics.
There are also concerns over the effectiveness of such campaigns in Guinea, as the latest outbreak of measles comes just a year after a nationwide vaccination effort against the virus.
Since the beginning of the year, roughly 3,500 measles cases have been confirmed in the country and 14 deaths, mostly in the capital city of Conakry and in Nzérékoré, Guinea’s second most populated city. In February, a measles epidemic was declared in 14 of 38 health districts in Guinea and an estimated 3.7 million children remain in “urgent need” of vaccination.
Measles is a highly contagious viral disease that mostly impacts children, and can be prevented with a vaccination. According to the World Health Organization, in 2015 there were about 370 measles deaths per day, mostly in sub-Saharan Africa. Although measles is highly contagious, it is also a treatable disease, but fatalities have decreased by 79 percent between 2000 and 2015 worldwide.
In partnership with the Ministry of Health in Conakry, MSF is mobilizing a nine-day campaign involving more than 1,600 health workers across 164 vaccination sites, to provide vaccinations to all children ages 6 to 10 in an effort to contain the epidemic. In addition, MSF will support 30 health centers across the city to care for children suffering with mild measles cases.
Alongside MSF, the international NGO Alliance for International Medical Action has been working in the southeast city of Nzérékoré, and to date, has vaccinated more than 148,000 sick children there. However, local doctors now say this small-scale response is not enough.
“Until we treat each district we will continue seeing the spread of infection as we have thus far,” said Dr. Charles Tehoua, a pediatrician at the Nzérékoré Regional Hospital working with ALIMA.
Reduced routine vaccinations during the Ebola outbreak of 2014 to 2015 may be to blame for the quick spread of the disease, which has spread to 17 districts. During the Ebola epidemic, most resources and attention gathered around the effective management and treatment of Ebola patients. The outbreak also heightened fears of health facilities due to the high fatality rate, which saw many patients die after leaving home for Ebola treatment. That has discouraged many families from seeking routine vaccinations for children at clinics, even though the country has been declared Ebola-free.
However, what is drawing even more concern among health experts is that the measles outbreak has occurred after a nationwide vaccination campaign last year, raising concerns over the effectiveness of the health care system in Guinea.
“The fact that a new epidemic occurs barely a year after a massive vaccination campaign is a worrying sign of the weakness of health care in Guinea,” MSF’s Guinea representative Ibrahim Diallo wrote in a statement. “Major problems remain in the health system, undermining its capacity to prevent and respond to outbreaks effectively and timely.”
The Ebola outbreak in West Africa, which killed more than 11,000 people, exposed the highly fragile general state of the health care systems in Guinea, Liberia and Sierra Leone. According to the United Nations Special Envoy on Ebola, less than 20 percent of funds disbursed went to support the recovery of each care system. Instead, a focus was placed on improving surveillance to assure early detection and response to outbreaks like Ebola.
“If Ebola was a wakeup call, since then the world seems to have fallen back asleep,” said Dr. Mit Philips, health policy analyst at MSF. “As shown by this measles outbreak, the concrete impact of the promises of funding, support and training made during and after the Ebola crisis still remains to be felt by ordinary Guineans. Access to good health care was clearly lacking before Ebola struck, and the country is still facing today the same problems that it was facing then, largely alone, in spite of the international public commitments to build better and more responsive health systems.”
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