Despite international recognition of the high burden of disease associated with measles and the existence for 40 years of a safe, effective, and inexpensive vaccine, measles remains the leading cause of vaccine-preventable childhood mortality. In 1990, the World Summit for Children adopted a goal of vaccinating 90% of the world's children against measles by 2000 (1). In 2001, the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) developed the Global Measles Strategic Plan for 2001-2005. The plan's objectives are 1) to decrease the annual number of measles deaths by 50% by 2005 compared with 1999 levels (875,000 deaths), 2) to achieve and maintain interruption of indigenous measles transmission in large geographic areas with elimination goals, and 3) to convene a global consultation in 2005 to review progress and assess the feasibility of global measles eradication. In May 2002, the United Nations General Assembly Special Session on Children also resolved to reduce measles deaths by 50% by 2005 compared with 1999 levels. This report describes progress toward eliminating measles worldwide. Data from WHO's Global Burden of Disease (GBD) project indicate that approximately 1.7 million vaccine-preventable childhood deaths occurred in 2000, of which 777,000 (46%) were attributed to measles. The measles deaths occurred overwhelmingly among children living in poor countries with inadequate vaccination services. To prevent these deaths, stronger political commitment is needed to provide all children worldwide with two opportunities for measles immunization.
In a flurry of announcements that came just weeks before it called a federal election, the federal government doubled the funding for its domestic HIV/AIDS strategy, doubled its contribution to the Global Fund to Fight AIDS, Tuberculosis and Malaria, and announced a significant contribution to the World Health Organization (WHO) 3 by 5 Initiative. AIDS organizations welcomed the announcements but were critical of the fact that the increased funding for the domestic strategy will take five years to implement. They also criticized the fact that funding for the global initiatives is not new money; it will come out of increases for development assistance previously announced.
The Ottawa Charter both gave health promotion a solid framework and health promoters an identity. Yet, health promotion has far from reached its potential in being internalized in public health politics. Advocacy for health is one of the core missions for health promotion and the 25-year celebration of the Ottawa Charter offers a free ride, instead of being a missed opportunity. WHO has not met the expectations in taking advantage of the momentum and outcomes from the long series of global health promotion conferences. The series represents a lifeline for health promotion. Concepts like healthy public policy, supportive environments, social determinants, health and human rights, whole of government, globalization and others have been elaborated and framed in a health promoting context. The downside is that the footprints have not been bold, in particular not internationally. An upside is the development of research and science, underscored by a rapid development of scientific journals, textbooks, academic institutions and posts. A question arising is whether practise and policy making are left behind, since implementation on a grand scale still is lacking? Further and future efforts must be devoted to explore the processes and art of policy making. There is a need for more narratives and more health promoters involving themselves in policy making and politics. Health promotion is as relevant for the twenty-first century as ever. The challenges and opportunities are evident; the increasing global burden of non-communicable diseases, ageing populations, harmful use of alcohol, social determinants and fair societies improved governance and more. Health promotion can add value and WHO can step up its engagement.