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WHO Announces Rubella-Free Status for Bhutan, Emphasizing Success of Vaccination Efforts

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The World Health Organization (WHO) South-East Asia Region announced that Bhutan and Timor-Leste have successfully eliminated rubella on July 21, a highly contagious viral infection that can cause severe illness and irreversible birth defects in newborns when contracted during pregnancy. The achievement was made possible through widespread vaccination efforts in these countries.

Bhutan had previously eliminated measles in 2017 and 2018, respectively, and have now reached another milestone by joining Maldives and Sri Lanka in achieving the elimination of both measles and rubella. This marks a significant triumph for the WHO South-East Asia Region’s flagship priority program aimed at eradicating these vaccine-preventable diseases by 2023.

The success can be attributed to the unwavering commitment of the government of Bhutan, along with the dedication of healthcare workers, volunteers, and partners. The active participation of communities also played a vital role in implementing robust vaccine-preventable disease surveillance and improving access to immunization services.
Dr. Poonam Khetrapal Singh, the Regional Director of WHO South-East Asia, expressed her congratulations to Bhutan and Timor-Leste for their remarkable achievement. She highlighted the pivotal role of strong government leadership and the collective efforts of health workers and communities in this public health triumph.

The decision to declare Bhutan and Timor-Leste rubella-free came after a thorough review of data provided by the countries during the Regional Verification Commission for Measles and Rubella Elimination meeting in Bangkok, Thailand, in June. The Commission concluded that both nations had successfully interrupted the transmission of endemic rubella virus for more than 36 months.

Despite this momentous achievement, the Regional Director also emphasized the need for continued vigilance against the risk of virus importation. To ensure sustained success, a post-elimination sustainability plan will be put into action, building on the strategies that led to the elimination of endemic measles and rubella.

The Commission, which convenes annually, confirmed that measles elimination has been maintained in Bhutan, DPR Korea, Maldives, Sri Lanka, and Timor-Leste, while rubella elimination was confirmed in Maldives and Sri Lanka. It recommended the documentation of lessons learned in achieving and sustaining measles and rubella elimination, including cross-border collaboration.

In addition to Bhutan and Timor-Leste’s success, there has been remarkable progress in endemic countries. The Commission acknowledged the strong political commitment, high-quality surveillance, well-functioning laboratory network, well-developed outbreak response plan, and ongoing efforts to address gaps in population immunity in accordance with WHO guidelines.

Recent WHO UNICEF estimates of national immunization coverage for the South-East Asia Region showed encouraging improvements. In 2022, coverage with the first dose of a measles-rubella-containing vaccine increased by 6 percent, reaching 92%, while coverage with the second dose jumped by 7 percentage points to 85%. Six countries in the Region, namely Bangladesh, Bhutan, India, Maldives, Sri Lanka, and Thailand, achieved a coverage of 95% or higher in 2022. Among them, Bhutan, Maldives, and Sri Lanka achieved more than 95% coverage with the second dose as well.
The WHO South-East Asia Region has set an ambitious target of achieving more than 95% coverage with two doses of the measles-rubella-containing vaccine in all districts of every country in the Region.

This journey towards elimination began in 2014 when Dr. Poonam Khetrapal Singh, the Regional Director of WHO South-East Asia, designated measles elimination and rubella control as flagship priority programs. The goal was revised in 2019 to focus solely on measles and rubella elimination by 2023. By that time, six countries – Bangladesh, Bhutan, Maldives, Nepal, Sri Lanka, and Timor-Leste – had achieved rubella control, and four – Bhutan, Maldives, DPR Korea, and Timor-Leste – had eliminated measles.

Rubella, also known as German measles or three-day measles, is a highly contagious viral infection recognizable by its distinctive red rash. While it may cause mild or no symptoms in most individuals, it poses a severe risk to unborn babies when contracted by pregnant women, leading to potentially life-threatening birth defects.

The measles-mumps-rubella (MMR) vaccine has proven to be highly effective in preventing rubella and provides lifelong protection. Widespread vaccination efforts have played a pivotal role in reducing rubella infections in many countries, but continued vigilance is necessary to ensure the virus does not resurge

The global community, including countries, partner agencies, and communities, has worked in unity over the years to protect children from measles and rubella, two major childhood killer and debilitating diseases, as affirmed by the WHO.

With the successful elimination of rubella in Bhutan and Timor-Leste, the WHO South-East Asia Region takes another step closer to its goal of eradicating measles and rubella, ensuring a healthier and safer future for the region’s populations.

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