Why Europe’s Measles Crisis is a Political Failure

Octavian Coman

Europe is fighting measles again. Authorities are partly to blame

Plenty of Europeans have the impression that measles is a disease of the past, health experts say. As a consequence, vaccination rates have dropped, not least in the countries now most affected: Romania and Italy. Photo: Pixabay

In Romania, measles has killed more than 30 people, mostly babies, in an outbreak that shows no sign of slowing. Since the first cases were reported in early 2016, the virus has infected around 7,650 people, turning the country into Europe’s worst hotspot for the disease.

It’s tempting to blame poverty. But while Romania is one of the poorest countries in the European Union, such outbreaks aren’t necessarily linked to a lack of development.

Italy has the second-highest number of measles cases in the EU: more than 3,300 this year alone. The disease has claimed two lives. In June, a six-year-old boy died in the northern city of Monza. The child's immune system was compromised because he had leukemia. According to regional authorities, he may have contracted measles from an older sibling who had not been vaccinated.

Along with Romania and Italy, the European Centre for Disease Prevention says measles is endemic in four other EU countries: Belgium, France, Germany and Poland.

Plenty of Europeans have the impression that measles is a disease of the past, health experts say. As a consequence, vaccination rates have dropped, not least in the countries now most affected: Romania and Italy.

The problem is compounded by years of campaigning by “anti-vaxxers” who believe it’s dangerous to inoculate children despite a body of scientific evidence showing that the benefits far outweigh the risks. 

Highly contagious, ​measles is transmitted via airborne respiratory droplets or by direct contact with the nasal and throat secretions of infected people. The main symptoms are fever, rash, cough, running nose and eye infection. Complications include pulmonary or brain infection.

As things stand, the best defence is a vaccine that’s been available for decades. The World Health Organization has long recommended that a combined measles, mumps and rubella (MMR) vaccine should be given to children in two doses a number of years apart.

The drop in vaccination rates can’t simply be blamed on public complacency and the strident voices of “anti-vaxxers”. Health experts also point to a failure of political will. They say some authorities haven’t done enough to allocate money and human resources to departments in charge of vaccinations.

They’ve also neglected to cut red tape, they say. And, in the case of Romania, they haven’t adopted regulations to ensure a constant supply of vaccines for the national immunisation programme.

“Everything starts with political commitment for me,” said Robb Butler, programme manager for vaccine-preventable diseases and immunisation at the European office of the World Health Organization, citing a lack of willingness to conduct large-scale immunisation campaigns.

“In Africa, in Asia, in the Americas, we see them conduct supplemental immunisation activities, which means we will do a campaign, we will go out for a two-week period and we will find the children who are not vaccinated and we will vaccinate them. Here in Europe, we do not have a history of using that tool to close immunity gaps.”

Some countries have been late to introduce the crucial second dose of MMR vaccine, Butler said. The consequence?

“Now they are having outbreaks in older populations who were not fully vaccinated when they were younger,” he said. “Italy will be a good example of this. But we have many Western European countries where we are seeing the characteristics of the outbreaks change. We are seeing that the measles affect older populations, not the younger populations as much.”

Another hot topic for politicians is deciding whether to make certain vaccines mandatory, including the MMR.

Italy has started the process with a new decree making vaccination compulsory, a move welcomed by health experts. But the bad news is this: if you only do it when there’s an outbreak, it’s already a little too late.

Octavian Coman is a Romanian freelance multimedia journalist based in Bucharest. For the Balkan Fellowship for Journalistic Excellence, he is investigating the return of measles in Romania and beyond.

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Octavian Coman

Octavian Coman is a Romanian multimedia journalist based in Bucharest.