Global immunization initiatives have significantly reduced measles deaths by 88% between 2000 and 2024, according to a report from the World Health Organization (WHO). The measles vaccine has saved nearly 59 million lives since the turn of the millennium. Despite this progress, an estimated 95,000 people, predominantly children under five, succumbed to measles in 2024. Although this represents one of the lowest annual death tolls recorded since 2000, each death from a preventable disease underscores the urgent need for enhanced vaccination efforts.
While fatalities have decreased, measles cases are surging worldwide. In 2024, there were approximately 11 million infections, nearly 800,000 more than pre-pandemic levels in 2019. Dr. Tedros Adhanom Ghebreyesus, WHO Director-General, remarked, “Measles is the world’s most contagious virus, and these data show once again how it will exploit any gap in our collective defences against it.” He emphasized that universal vaccination could avert costly outbreaks and save lives, ultimately leading to the elimination of the disease.
The increase in measles cases is alarming, particularly in regions such as the WHO Eastern Mediterranean Region, which saw an 86% rise in cases, followed by a 47% increase in the European Region and 42% in South-East Asia compared to 2019. Conversely, the African Region reported a significant decline, with a 40% reduction in cases and a 50% drop in deaths, attributed to improved immunization coverage.
Even in regions where child mortality is lower due to better nutrition and healthcare access, those infected with measles face serious health risks. Complications from the virus can lead to lifelong issues such as blindness, pneumonia, and encephalitis, which causes brain swelling. According to WHO/UNICEF estimates, 84% of children received their first dose of the measles vaccine in 2024, while only 76% received the second dose. This marked a slight improvement from the previous year, with 2 million more children immunized. Nevertheless, the WHO advises that at least 95% coverage with two doses is necessary to halt transmission and protect communities.
In 2024, over 30 million children remained under-vaccinated against measles, with three-quarters of them located in the African and Eastern Mediterranean regions. These areas often face challenges related to conflict and vulnerable settings. The Immunization Agenda 2030 (IA2030) Mid-Term Review, also released recently, highlights that measles tends to resurge first when vaccination rates decline.
The ongoing measles outbreaks are revealing critical weaknesses in immunization programs and health systems worldwide, posing a threat to progress towards IA2030 targets, which include the goal of measles elimination. In 2024, 59 countries reported significant or disruptive measles outbreaks, nearly triple the number reported in 2021, representing the highest count since the COVID-19 pandemic began. Notably, all regions except the Americas had at least one country experiencing a large outbreak in 2024, a situation that shifted in 2025 when numerous countries in the Americas began battling their own outbreaks.
Efforts to enhance measles surveillance have improved the ability of WHO and various countries to identify and respond to outbreaks effectively. In 2024, more than 760 laboratories within the Global Measles and Rubella Laboratory Network (GMRLN) evaluated over 500,000 samples, reflecting a 27% increase from the previous year. However, substantial funding cuts affecting GMRLN and country immunization programs raise concerns that these gaps may widen, potentially triggering further outbreaks in the coming year.
Achieving sustainable domestic financing and engaging new partners is now a critical challenge to advancing global efforts towards a world free of measles. The elimination target outlined in IA2030 appears distant, as only 81 countries (or 42%) had eliminated measles by the end of 2024, representing only three additional countries since before the pandemic. Progress has occurred in 2025 with Pacific island nations verified for measles elimination and countries such as Cabo Verde, Mauritius, and Seychelles joining the ranks as the first verified nations in the WHO African Region.
The Region of the Americas temporarily regained measles elimination status in 2024 but lost it again in November 2025 due to ongoing transmission in Canada. The resurgence of measles in recent years has affected even high-income countries that once eliminated the disease, primarily due to immunization rates falling below the 95% threshold. Localized outbreaks often arise in communities with lower vaccination coverage, leaving populations at risk.
To reach the goal of measles elimination, a strong political commitment alongside sustained investment is essential. Ensuring that all children receive two doses of the measles vaccine and that surveillance systems can swiftly detect outbreaks is paramount. The IA2030 Mid-Term Review calls for enhanced routine immunization, robust surveillance, and rapid outbreak response capabilities, as well as high-quality vaccination campaigns to protect every child effectively.
