Contributor(s)The University of Newcastle. Faculty of Health & Medicine, School of Medicine and Public Health
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AbstractIn their Global Burden of Disease Study (Sept 13, p 957), Haidong Wang and colleagues quaintly conclude, after their thorough analysis of mortality in children younger than 5 years old during 1990–2013, that secular trends account for most of the mortality reduction. They incorrectly attribute this reduction to new drugs (specifically antiretroviral therapy), new vaccines (specifically rotavirus and pneumococcal vaccines), and the “dominant role of new technologies”. Disappointingly, the contribution of old vaccines, particularly the measles vaccine, is not mentioned in the study. The increase in global coverage with the measles vaccine has made a profound contribution to the reduction in childhood mortality, with a 74% reduction in childhood deaths attributed to measles from 535 300 in 2000 to 139 300 in 2010. Furthermore, reductions in measles mortality accounted for 23% of the estimated decrease in all-cause child mortality from 1990 to 2008. The call for further technology innovation is welcomed, but this should not be at the cost of achievable and sustainable universal coverage with well proven life-saving methods, particularly the measles vaccine. Insufficient investment, poor political commitment, and inadequate health-system effort in the delivery of two doses of measles vaccine to every child will jeopardise the encouraging progress towards reaching Millennium Development Goal 4 and will cost many young children's lives.