Four countries eliminated measles, and the region got worse

In 2015, **all 22 countries and areas of the WHO Eastern Mediterranean Region
pledged to eliminate measles by 2020.**

During 2019–2022, four achieved it. Over the same period:

Four successes and a region going backwards is not a contradiction. It is what
an average made of very different countries looks like: elimination is achieved
where health systems function, and incidence is driven by the places where they
do not.

Why 82% is not nearly enough

Measles needs roughly 95% coverage with two doses to stop circulating,
because it is the most contagious disease there is. **82–83% for one dose and
76–78% for two** leaves a susceptible fraction that grows with every birth
cohort — so incidence rises even when nothing else changes.

The second-dose figure is the one to watch. A child with one dose is mostly
protected; the second exists to catch the small share in whom the first did not
take, and it is the dose most often missed.

The part that makes the rest harder to fix

Surveillance performance deteriorated.

Measles control depends on finding cases fast enough to vaccinate around them.
Weaker surveillance means outbreaks are found later, when the ring of contacts
is larger — so the same coverage buys less control than it did.

That is also why the incidence figure should be read as a floor. A region whose
surveillance has degraded is a region finding a smaller share of its cases, and
50.0 per million is what was detected.

Most countries in the region still have not eliminated measles, and the
pledge's deadline has passed.

Source: Centers for Disease Control and Prevention, MMWR.