Innovative Use of Surveillance Data to Harness Political Will to Accelerate Measles Elimination: Experience From Guangxi, China

Division of Immunization Service, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
The Journal of Infectious Diseases (Impact Factor: 6). 07/2011; 204 Suppl 1(Supplement 1):S463-70. DOI: 10.1093/infdis/jir064
Source: PubMed


The major challenge for measles elimination is to harness sufficient political will to provide the necessary financial and
human resources. This is particularly relevant for local governments (at county and township levels in China) and communities
that generally have not accepted measles as a serious health burden and thus have not made its prevention a high priority.
An effort has been made to use surveillance data to harness political will and overcome or mitigate the shortage of resources
in the impoverished province of Guangxi, one of China's 31 administrative divisions. A comprehensive information system collecting
data pertaining to Expanded Program on Immunization (EPI-info) was refined to align with China's political system and translate
international and national commitments into sustainable local actions. The EPI-info has proved an effective tool in identifying
high-risk areas, strengthening routine immunization services, conducting mass measles immunization campaigns, and catalyzing
capacity building at both county and local community levels. We outline the principles and operational features of the EPI-info
and the rationale and steps taken to refine it.

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    ABSTRACT: Because of limited resources, each year during the period from 1999 through 2007, only about one-quarter of the 111 counties in Guangxi province were selected by means of risk assessment to participate in Supplementary Immunization Activities (SIAs), targeting children aged 8 months to 14 years during 1999–2003 and 8 months to 10 years during 2004–2007. Approximately 2 million doses of measles vaccines were administrated each year during SIAs. Estimated from the National Notifiable Diseases Surveillance System, with a reliable internal consistency over years, the average annual incidences of measles before SIAs (1993–1998), during the first phase (1999–2003), and during the second phase (2004–2007) were 16.05, 9.10, and 2.46 cases per 100,000, respectively. The overall provincewide annual incidence decreased by 84.67%, from 12.12 cases per 100,000 in 2000 to 2.10 cases per 100,000 in 2007. The percentage of counties with annual incidence ≥10 cases per 100,000 decreased from 55% in 1993 to <1% in 2007. Compared with the pre-SIA period, the greatest decrease in annual incidence was 83.93% for the 10–14.9-year-old group and the smallest decrease was 46.16% for children <1 year old. The multiple-year SIAs targeting children in selected high-risk counties were effective in controlling measles in mountainous, impoverished, and multiethnic measles-endemic areas.
    Preview · Article · Jul 2011 · The Journal of Infectious Diseases

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    ABSTRACT: Critical to the advancement of vaccinology is the development of new vaccines available to meet both existing and emerging infectious disease threats. However, while underappreciated, new vaccines are not used in a vacuum. Rather, their use heavily depends on a variety of political, ethical, social, and psychological issues and considerations that at the individual and population level determine whether such vaccines are actually used. In this chapter we explore these aspects and how they mold and impact vaccine policy, uptake, and the success or failure of immunization programs.
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