Sucre Agreement - Bolivia, 22-23 April 2002
 On April 23, 2002, the Ministers of the Andean Region and Chile signed an agreement in the city of Sucre, Bolivia, aimed at preventing the regionalization of the measles outbreak that is currently affecting Venezuela. The Sucre Agreement calls for countries in that Andean region to adequately finance national immunization programs; carry out vaccination campaigns on a timely basis; coordinate the simultaneous implementation of national immunization weeks, beginning in 2003; and maintain active epidemiological surveillance at all levels, using active case-finding as a routine strategy in high risk areas.
Since September 2001, Venezuela has been affected with a measles outbreak, following an importation from Europe. As of late April 2002, a total of 1,820 confirmed measles cases and one death have been reported in 11 States. Most cases are among unvaccinated populations. Highest rates of infection are in the under 5 age group, followed by young adults. Adult population groups affected include migrant workers, students, and health care workers. The State hardest-hit is Zulia, which is the most populated in the country and borders with Colombia. As of late April, 2002, Colombia had reported 13 confirmed measles cases, all due to importations from Venezuela. The re-establishment of measles transmission in Venezuela can be traced to that country's persistently low vaccination coverage levels achieved through routine immunization services in several areas. Between 1995 and 1997, routine vaccination coverage for 1-year olds was below 70%, in 1999 it increased to 80%, and in 2000 to 84%.
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