Global health authorities are raising concern over a renewed global measles resurgence, as new World Health Organization (WHO) data reveal a paradoxical trend of sharply rising infections despite sustained declines in mortality. Between 2000 and 2024, measles deaths fell by 88%, largely due to expanded immunization coverage, with an estimated 59 million lives saved through vaccination. However, this progress is increasingly threatened by widening immunity gaps and declining vaccine uptake in several regions.
In 2024, an estimated 95,000 measles-related deaths were reported worldwide, the majority occurring in children under five years of age. Although this represents one of the lowest annual death totals on record, WHO emphasizes that measles remains a fully preventable cause of morbidity and mortality, given the availability of a safe, cost-effective, and highly efficacious two-dose vaccine regimen.
At the same time, global measles incidence rose to an estimated 11 million cases in 2024, nearly 800,000 more than in 2019, the last year before the COVID-19 pandemic. Substantial regional increases were reported, with an 86% rise in the Eastern Mediterranean Region, 47% in Europe, and 42% in South-East Asia. Africa was the only region to record a decline, with cases falling by 40% and deaths by 50%, a trend attributed to improvements in routine immunization and supplemental vaccination campaigns in several countries.
Public health experts note that the divergence between declining mortality and increasing incidence reflects improved clinical management and health system capacity in some outbreak-prone regions. While survival has improved, measles continues to impose a significant clinical burden. Severe complications such as pneumonia, acute encephalitis, vision loss, and long-term neurodevelopmental impairment remain common, particularly in malnourished children and those with limited access to timely care. Measles infection also causes prolonged immune suppression, increasing susceptibility to secondary infections for months to years following acute illness.
Global vaccination coverage remains well below the threshold required to interrupt transmission. In 2024, approximately 84% of children received a first dose of a measles-containing vaccine, while only 76% received the recommended second dose. Although 2 million additional children were vaccinated compared with 2023, coverage remains far short of the 95% required to prevent outbreaks and achieve elimination. More than 30 million children worldwide remain under-immunized, with nearly three-quarters residing in the African and Eastern Mediterranean regions, often in settings affected by conflict, displacement, or fragile health infrastructure.
The WHO Immunization Agenda 2030 (IA2030) Mid-Term Review highlights measles as a sensitive tracer of immunization system performance, noting that it is frequently the first vaccine-preventable disease to resurge when routine services weaken. The current increase in outbreaks underscores systemic vulnerabilities in primary healthcare delivery, surveillance, and community engagement, placing global measles elimination targets at risk.
In 2024, 59 countries reported large or disruptive measles outbreaks, nearly triple the number recorded in 2021 and the highest since the COVID-19 pandemic. All WHO regions reported at least one major outbreak, and by 2025, the Americas also experienced renewed widespread transmission, reversing previously regained elimination status.
Enhanced laboratory surveillance has improved outbreak detection and response. The Global Measles and Rubella Laboratory Network, comprising more than 760 laboratories, tested over 500,000 specimens in 2024, a 27% increase from the previous year. However, WHO warns that recent funding constraints threaten laboratory capacity, surveillance quality, and timely outbreak response, increasing the risk of undetected transmission and further immunity gaps.
Progress toward elimination remains uneven. By the end of 2024, only 81 countries had achieved verified measles elimination, a marginal increase compared with pre-pandemic levels. In 2025, renewed progress was documented in several Pacific island nations and African countries, including Cabo Verde, Mauritius, and Seychelles, bringing the global total to 96 countries. Nonetheless, even high-income settings are experiencing resurgence as vaccination coverage declines below critical thresholds and clusters of unvaccinated individuals sustain transmission.
Reference
- World Health Organization (WHO) [Internet]. [cited 2025 Nov 29]. Available from: https://www.who.int