The measles emergency is over, but the crisis continues ,a call to action for the Pacific Islands

Abstract

On 15 November 2019, the Government of Samoa declared a state of emergency for the country due to a measles epidemic. The following six weeks were marked by closure of schools, prohibition of children at public gatherings, intensive immunization campaigns, curfews, and re-distribution of health resources and services to manage the overwhelming influx of measles patients. The state of emergency was lifted on the 29th of December 2019. According to the Joint WHO/UNICEF Pacific Islands Measles Outbreak Situation Report (8 January 2020), there was a total of 5697 measles cases (Total population of Samoa in 2016: 195 000) [1]. There were 83 measles-related deaths, with 87% of these among children under 5 years of age. There were 1860 measles-related hospital admissions, and 95% of cases recovered and were discharged. Samoa is now in a state of recovery. Although the measles emergency is over, the health system should now turn its attention to managing the complications that may arise following acute measles infection. This includes the permanent disabilities of hearing, visual, and cognitive impairment [2-4]. It is also a time to review the national immunization program, and investigate areas for improvement. Research audiologist (author AK) is on assignment in Samoa for two years, and has previously published a viewpoint in this journal advocating for a public health approach to childhood hearing impairment in the Pacific Islands [5]. The current state of recovery in Samoa presents an ideal opportunity for the Ear, Nose, and Throat (ENT) Clinic to implement this principle. The Acting Head of the ENT Clinic and Surgeon (author SP) was a member of the Ministry of Health planning committees during the measles crisis, and continues to be part of the recovery committee. He is ideally placed to advocate for the inclusion of surveillance/screening for ear and hearing disorders among measles survivors in the recovery plan. Measles outbreaks were also reported in Fiji, Tonga, and American Samoa during October-December 2019. The aim of this viewpoint is to highlight the Samoan experience, and to urge other Pacific Islands nations to review their advocacy, approach, and management for preventable disease and disability. The Sustainable Development Goal (SDG) Project offers an ideal platform to implement strategies aimed at improving immunization programs, as well as improving childhood developmental health through public health service delivery.