Measles Control in Pacific Island Countries and Territories

Historically, measles has been a public health concern since the nineteenth century in Pacific Island Countries and Territories (PICTs). Now, despite significant progress, immunization programmes in these countries face many challenges, gains remain fragile, and outbreaks continue to occur. While most PICTs have achieved relatively high measles vaccine coverage, they need to achieve and sustain very high coverage of two doses of measles vaccine for each annual cohort of infants to prevent a build-up of unimmunized children and the risk of a measles outbreak. In line with global experience, there are indications of stagnation in routine coverage in recent years in some countries, resulting in an on-going risk of an outbreak if measles virus were to be imported from neighbouring countries. PICTs tend to experience a range of difficulties related to delivery of immunization services that are specific to the island environment. Challenges include generalized systemic weaknesses in the health system; ensuring the supply of vaccines to remote locations; frequent natural disasters such as cyclones; highly mobile populations; and pressure on limited resources. If governments become more pressured from the mounting epidemics of non-communicable diseases, funding for immunization services may suffer as a consequence. The support of international stakeholders for measles control will remain essential for many PICTs for the foreseeable future.