A new World Health Organization (WHO) report shows that while measles deaths have dropped dramatically over the past two decades, the number of infections is once again surging across the world.
According to the WHO, global immunisation efforts have led to an 88 per cent reduction in measles deaths between 2000 and 2024, saving nearly 5.9 crore lives during this period. Yet, in 2024 alone, an estimated 95,000 people, mostly children under the age of five, died due to measles.
Although this is among the lowest annual death tolls since 2000, experts stress that every death from a preventable disease is one too many.
More worrying is the sharp rise in infections. The report estimates that 1.1 crore measles cases were recorded globally in 2024, nearly 8 lakh more than pre-pandemic levels in 2019. This resurgence is being driven by gaps in vaccination coverage, fragile health systems, conflict, misinformation, funding cuts, and disruptions to routine healthcare following the COVID-19 pandemic.
WHO also highlights that “significant progress has been made in the past 24 years towards this goal. However, persistent challenges and disparities within and between countries and regions now threaten past achievements and future progress, with several countries at risk of losing their elimination status.”
What is measles, and how does it spread?
Measles is a highly contagious viral illness caused by the measles virus of the Morbillivirus genus. It primarily affects children and spreads easily from person to person. The disease begins with high fever, cough, runny nose, and red, watery eyes, followed by the appearance of Koplik’s spots - small white lesions inside the mouth. A few days later, a characteristic red or purplish rash appears on the face and gradually spreads to the neck, trunk, arms, and legs.
While many people associate measles only with a skin rash, doctors caution that it is far more dangerous than it appears. Measles can lead to severe complications such as pneumonia, blindness, severe diarrhoea with dehydration, and brain inflammation (encephalitis). In rare cases, it can cause subacute sclerosing panencephalitis (SSPE), which is a fatal neurological condition that develops years after recovery from measles.
The virus spreads through the air when an infected person coughs, sneezes, talks, or even breathes. The infectious droplets can remain suspended in the air or settle on surfaces for up to two hours, making measles one of the most transmissible diseases. A person remains contagious from four days before the rash appears to four days after its onset, allowing the virus to spread rapidly before detection.
There is no specific antiviral treatment or cure for measles. Medical care focuses on managing symptoms, preventing complications, and addressing secondary infections. Vitamin A may be administered under medical supervision to reduce the severity of complications, particularly in children. However, the only truly effective protection against measles is vaccination with two doses of the measles-containing vaccine (MCV), which provides long-term immunity.
Measles deaths down, but transmission rising
The WHO report highlights a striking global trend - measles deaths have declined sharply, but transmission is increasing. Between 2000 and 2024, intensive vaccination campaigns helped prevent millions of deaths. Yet, in 2024 alone, 1.1 crore people were infected worldwide, marking a significant rebound in cases.
Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, warned that the virus exploits every weakness in public health systems. “Measles is the world's most contagious virus, and these data show once again how it will exploit any gap in our collective defences against it. Measles does not respect borders, but when every child in every community is vaccinated against it, costly outbreaks can be avoided, lives can be saved, and this disease can be eliminated from entire nations,” he said.
Regional data reveal sharp contrasts. Compared to 2019, “measles cases in 2024 increased by 86 per cent in the WHO Eastern Mediterranean Region, 47 per cent in the European Region, and 42 per cent in the South-East Asian Region. Notably, the African Region experienced a 40 per cent decline in cases and 50 per cent decline in deaths over this period, partly due to increasing immunisation coverage.”
The report notes that despite recent measles surges occurring in countries and regions where children are less likely to die due to better nutrition and access to healthcare, those who are infected “remain at risk of serious, lifelong complications such as blindness, pneumonia, and encephalitis (an infection causing brain swelling and potentially brain damage).”
Immunisation coverage still far below the safety threshold
A major reason behind the global resurgence of measles is insufficient vaccine coverage. In 2024, an estimated 84 per cent of children worldwide received their first dose of the measles vaccine, while only 76 per cent received the second dose, according to WHO and UNICEF estimates. Although this reflects a small improvement from previous years, it remains dangerously below the 95 per cent coverage required to stop measles transmission and achieve herd immunity.
Alarmingly, more than 3 crore children worldwide remained under-protected against measles in 2024. Nearly three-quarters of these children live in the African and Eastern Mediterranean regions, often in conflict-affected, fragile, or underserved communities where healthcare access is limited.
The Immunization Agenda 2030 (IA2030) Mid-Term Review warns that “measles is often the first disease to resurge when vaccination coverage drops. Growing measles outbreaks are exposing weaknesses in immunisation programmes and health systems globally, and threatening progress towards IA2030 targets, including measles elimination.”
Outbreaks rising amid funding cuts and surveillance challenges
The year 2024 witnessed a sharp rise in large or disruptive measles outbreaks. Fifty-nine countries reported major outbreaks, nearly three times the number reported in 2021, making it the highest global outbreak count since the beginning of the COVID-19 pandemic. Every WHO region, except the Americas, reported at least one large outbreak in 2024. However, the scenario worsened in 2025, with multiple countries in the Americas also battling fresh outbreaks.
Improved surveillance systems have helped detect cases earlier. In 2024, “more than 760 laboratories participating in the Global Measles and Rubella Laboratory Network (GMRLN) tested over 500,000 samples, an increase of 27 per cent from the previous year.” This enhanced surveillance has strengthened outbreak detection and response in several countries.
However, the WHO has raised serious concerns about deep funding cuts affecting both GMRLN and national immunisation programmes. These financial constraints threaten to widen immunity gaps, weaken outbreak response, and accelerate the spread of measles in vulnerable populations. Securing sustainable domestic financing and new global partnerships is now seen as one of the most urgent challenges in the global fight against measles.
Situation worsening in 2025
In fact, the situation may be worsening in 2025. In the United States of America, the Centers for Disease Control and Prevention says that there have been 46 outbreaks reported in the country this year, and about 87 per cent of all the cases were related to these outbreaks. "For comparison, 16 outbreaks were reported during 2024 and 69 per cent of cases (198 of 285) were outbreak-associated," it said.
In fact, the 1828 cases reported in the US so far is the highest number of such instances the country has in at least 25 years. The last time the country saw a similar spike in measles cases appears to be in 2019, when there were 1274 cases reported in the country.
In August, the WHO from the Americas regions had also said that "As of 8 August 2025, a total of 10,139 confirmed measles cases and 18 related deaths have been reported across ten countries, representing a 34-fold increase compared to the same period in 2024."
Doctors without Borders had said that similar spikes were seen in Afghanistan as well. "There were 664 patients admitted in the first eight weeks of 2025, a 180 per cent increase in the number of cases compared to the same period in 2024," according to their data.
The significance for India
Provisional data reported to the World Health Organization from April to October 2025 places India fifth among the top ten countries with measles outbreaks, with 8,035 reported cases.
Earlier this year, Union Health Minister Jagat Prakash Nadda launched the National Zero Measles-Rubella Elimination Campaign 2025–26 during World Immunisation Week (April 24–30). Calling it a crucial step towards eliminating the diseases by 2026, he said, “The launch of Measles-Rubella elimination campaign 2025-26 marks an opportunity to achieve 100 per cent immunisation coverage to provide a high-quality lifestyle to children by administering them with the two doses of Measles and Rubella vaccine.”
He noted that 332 districts reported zero measles cases and 487 districts reported zero rubella cases between January and March 2025, and urged states to strengthen surveillance through the Integrated Disease Surveillance Programme (IDSP), adopting an “ACT NOW” approach similar to past polio elimination efforts. He also stressed last-mile outreach, community participation through Jan Bhagidari, and focus on slums, migratory populations and outbreak-prone areas.
Under the Universal Immunisation Programme (UIP), two free doses of the Measles-Rubella (MR) vaccine are provided at 9–12 months and 16–24 months. As per HMIS 2024–25 data, India’s MR coverage stands at 93.7% for the first dose and 92.2% for the second dose. In 2024, measles cases declined by 73% and rubella cases by 17% compared to 2023.
Prof. Dr Sanjeev Bagai, Padma Shri awardee and Senior Consultant Paediatrician & Nephrologist, described measles as “the most contagious viral infection known to mankind.” He explained that the virus has an R₀ (reproductive number) of 8 to 13, which means “one infected child can potentially spread the disease to thousands within weeks,” even in largely vaccinated communities.
Dr Bagai noted that “while India follows a strong immunisation schedule, a measles dose at 8–9 months, MMR at 14 months, and a booster at 3–5 years, global vaccination coverage dipped sharply during and after COVID-19 due to lockdowns and supply-chain disruptions.”
He stressed that the focus is now returning to vaccination, especially in regions affected by conflict, poverty and anti-vaccine misinformation. Dismissing vaccine safety myths, he said, “There is absolutely no scientific evidence, none at all, even in large meta-analyses published in journals like The Lancet, linking vaccines to autism or neurodevelopmental disorders.”
On India’s 2026 elimination target, Dr Bagai expressed cautious optimism. While he believes India can achieve elimination through aggressive door-to-door vaccination and surveillance, he warned that “vaccination can never be made legally compulsory.” He pointed out that “religious beliefs, misinformation, vaccine hesitancy and gaps in last-mile delivery remain the biggest reasons for missed or delayed measles vaccination, both in India and globally.”
This story is done in collaboration with First Check, which is the health journalism vertical of DataLEADS.