Largest Integrated Health Campaign Ever Saves Children From Africa’s Two Leading Killers — Malaria and Measles

Community Survey Shows Successful Widespread Delivery Of Multiple Health Interventions In Togo During December's Nationwide Vaccination Campaign

Washington, D.C.

May 4, 2005


Megan Rabbitt

During the largest integrated health campaign ever, held in Togo last December, more than 800,000 insecticide-treated nets (ITNs) to help prevent malaria were distributed along with the measles and polio vaccines and de-worming medicine (mebendazole). The campaign demonstrated that it is possible to successfully implement multiple health interventions on a national scale.

The Measles Initiative strategy supports national vaccination campaigns for African children during a period of up to two weeks. Such campaigns draw mothers and children from wide areas and offer one-stop shopping for much needed lifesaving health interventions for free. So far, the Initiative has vaccinated more than 150 million children, saving 400,000 lives. Before the Measles Initiative began in 2001, measles killed more than 480,000 children each year in Africa, but because of the Initiative’s success that number has been reduced by half.

“There are not as many cases of measles here, as children are now very well vaccinated in this area thanks to the last measles vaccination campaign,” said Dr. Lawson-Hukpate, director of social work for the Hospital Amis des Bebes in Togo. “But we still see a lot of malaria, in children and adults.”

Malaria kills nearly a million African children under 5 years old each year, more than any other single infection. Every day 3,000 children die from the disease; those who survive may suffer from brain damage or paralysis. ITNs are one of the very best ways to protect against malaria. When the Measles Initiative began in 2001, it offered free measles vaccines and vitamin A during campaigns. After proven success in reaching more than 90 percent of the targeted age group during each campaign, the Initiative began adding other lifesaving interventions into its campaigns including ITNs.

ITNs are key components in fighting death and illness due to malaria. Malaria is the number one cause of child mortality in Africa, killing nearly 1 million children below 5 years of age each year. Ninety percent of deaths due to malaria worldwide occur in sub-Saharan Africa.

“This was the best Christmas present for all children under five in Togo,” said Togo’s Minister of Health, Suzanne Aho. “But, we must protect all African children not just the children of Togo. This is important for all of Africa. We hope to extract lessons learned from this experience to share with other countries.” The Ministry of Health deployed nearly 2,000 vaccinators and 2,500 volunteers and provided vehicles and vaccination sites.

The Centers for Disease Control and Prevention (CDC) carried out a community-based, cross-sectional survey in 12 districts in Togo one month after the December integrated health campaign. The survey provided data on delivery of services during the campaign, including measles and polio vaccinations, mebendazole and distribution of free ITNs. The survey is part of the evaluation of the impact of wide-scale distribution of ITNs to all households (HH) with young children. There were 2,254 households interviewed, of which, 77 percent had at least one child less than 5 years of age for a total of 2,599 children.


Results in weighted analysis include:
• 96 percent of eligible children attended the campaign
• 91 percent of eligible children received an ITN
• 93 percent of eligible children received a measles vaccination
• 94 percent of eligible children received a polio vaccination
• 93 percent of eligible children received mebendezole for de-worming

“Malaria outbreaks are highest during the rainy season which will start in the next few months,” said
Dr. Mark Grabowsky, senior technical advisor for the American Red Cross on loan from the CDC. “An important part of ITN distribution is not only to make sure each family owns a net but that they know how to hang it and make sure that in particular, every child and pregnant woman sleeps under it. Togolese Red Cross volunteers will go house to house over the next few months continuing to educate families about proper ITN use.”

“The enthusiasm of the Togolese health workers was overwhelming,” said Jean Roy, senior public health advisor, International Federation of Red Cross and Red Crescent Societies. “They knew they were giving families something that could help their children stay healthy.” The Measles Initiative works closely with governments of countries affected by measles, African communities and partners to make sure each at-risk child is reached with free measles vaccinations and other appropriate health interventions.

For the Togo campaign, significant contributions were made by the Canadian International Development Agency (CIDA), Norwegian Aid, The Vaccine Fund, the Gates Foundation, Vodafone Foundation, DHL, Sanofi-Synthelabs and Vestergaard-Frandsen. The International Federation of Red Cross and Red Crescent Societies, Canadian Red Cross, Norwegian Red Cross and New Zealand Red Cross also made important financial contributions. Social mobilization, the process to educate and encourage families to bring their children to be vaccinated, is being carried out by more than 10,000 Togolese Red Cross volunteers, the Peace Corps and Freedom from Hunger. In addition, Air France has committed 90 airline tickets to the Measles Initiative over the next two years.

Launched in February 2001, the Measles Initiative is a long-term commitment to control measles deaths in Africa by vaccinating 200 million children and preventing 1.2 million deaths over five years. Leading this effort is the American Red Cross, United Nations Foundation, Centers for Disease Control and Prevention (CDC), United Nations Children’s Fund (UNICEF) and the World Health Organization (WHO). Other key players in the fight against measles include the International Federation of Red Cross and Red Crescent Societies, the Canadian International Development Agency (CIDA) and countries and governments affected by measles. While the Measles Initiative is focused in Africa where the majority of measles-related deaths occur, partners also work on a wide-range of health initiatives around the world, including measles control and other vaccination services outside of Africa.

For more information about the Measles Initiative, log on to To make a financial contribution, call 1-800 HELP NOW or to make a secure online donation, log on to


Spokespeople are available from the Measles Initiative partners and workers and volunteers in Africa. Video footage from recent measles campaigns is available at


Julie Irby, American Red Cross (202) 303-4264 office (M/F), (202) 439-0722 cell,

UN Foundation (202) 887-9040

Hayatee Hasan, WHO (41) 22 791 21 03 office,

Erica Kochi, UNICEF (914) 772-9954 cell,

Steve Stewart, CDC (404) 639-8327 office,