After achieving a historic return to measles elimination and a 98% drop in cases in 2024, the Region of the Americas now faces renewed transmission in 2025.
28 November 2025 | Geneva / Washington, D.C. – Global immunization efforts have led to an 88% drop in measles deaths between 2000 and 2024, according to a new report from the World Health Organization (WHO). Nearly 59 million lives have been saved by the measles vaccine since 2000.
However, an estimated 95 000 people, mostly children younger than 5 years of age, died due to measles in 2024. While this is among the lowest annual tolls recorded since 2000, every death from a disease that could be prevented with a highly effective and low-cost vaccine is unacceptable.
Despite fewer deaths, measles cases are surging worldwide, with an estimated 11 million infections in 2024 – nearly 800 000 more than pre-pandemic levels in 2019.
“Measles is the world's most contagious virus, and these data show once again how it will exploit any gap in our collective defenses against it,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “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.”
Measles cases in 2024 increased by 86% in the WHO Eastern Mediterranean Region, 47% in the European Region, and 42% in South-East Asian Region compared with 2019. Notably, the African Region experienced a 40% decline in cases and 50% decline in deaths over this period, partly due to increasing immunization coverage.
The Region of the Americas, by contrast, achieved a 98% reduction in estimated cases (from 116 365 in 2019 to just 2 320 in 2024) and saw measles deaths fall to essentially zero. No country in the Americas experienced a large or disruptive outbreak in 2024 – the only WHO region to record none. This progress allowed the region to be reverified for measles elimination in 2024, a historic milestone as the only WHO region ever to have achieved regional elimination (first in 2016, regained in 2024 after Venezuela’s re-verification in 2023 and Brazil’s in 2024).
Yet this hard-won success proved fragile. Although first-dose measles vaccination coverage in the Americas recovered to 88% in 2024 –above the global average of 84%– it remained below the 95% or more required at national and subnational levels to prevent outbreaks and sustain elimination. Pockets of under-vaccinated communities, combined with imported cases, resulted in outbreaks in several countries in 2025, leading to sustained transmission in Canada and the loss of measles elimination status for both Canada and the Region of the Americas as of November 2025.
While recent measles surges are occurring in countries and regions where children are less likely to die due to better nutrition and access to health care, those infected remain at risk of serious, lifelong complications such as blindness, pneumonia, and encephalitis (an infection causing brain swelling and potentially brain damage). However, measles can have far more severe consequences in vulnerable populations —such as Indigenous peoples in the Americas and immunocompromised individuals— where mortality and case-fatality rates are disproportionately higher.
Immunization coverage insufficient to protect all communities
In 2024, an estimated 84% of children received their first dose of the measles vaccine, and only 76% received the second, according to WHO/UNICEF estimates. This is a slight improvement from the previous year, with 2 million more children immunized. According to WHO guidance, at least 95% coverage with two measles vaccine doses is required to stop transmission and protect communities from outbreaks.
More than 30 million children remained under-protected against measles in 2024. Three-quarters of them live in the African and Eastern Mediterranean regions, often in fragile, conflict-affected or vulnerable settings.
The Immunization Agenda 2030 (IA2030) Mid-Term Review, also released today, stresses that measles is often the first disease to resurge when vaccination coverage drops. Growing measles outbreaks are exposing weaknesses in immunization programmes and health systems globally, and threatening progress towards IA2030 targets, including measles elimination.
Rising number of outbreaks
In 2024, 59 countries reported large or disruptive measles outbreaks – nearly triple the number reported in 2021 and the highest since the onset of the COVID-19 pandemic. All regions except the Americas had at least one country experiencing a large outbreak in 2024.
Efforts to scale up measles surveillance have improved WHO and countries' abilities to identify and respond to outbreaks, and for some countries to achieve elimination. 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% from the previous year.
However, deep funding cuts affecting GMRLN and country immunization programmes are feared to widen immunity gaps and drive further outbreaks in the coming year. Securing sustainable domestic financing and new partners is now a critical challenge to advancing efforts toward a world free of measles.
Striving for a measles-free world
The world’s elimination goal, as laid out in IA2030, remains a distant one. By the end of 2024, 81 countries (42%) had eliminated measles, only three additional countries since before the pandemic.
Additional progress has been made in 2025 with Pacific island countries and areas verified in September 2025, and Cabo Verde, Mauritius and Seychelles verified this month, becoming the first countries in the WHO African Region to be verified for measles elimination. This brings the total number of countries that have eliminated measles to 96. In the Americas, all countries except Canada continue to maintain their elimination status.
Measles has resurged in recent years, even in high-income countries that once eliminated it, because immunization rates have dropped below the 95% threshold. Even when overall coverage is high nationally, pockets of unvaccinated communities with lower coverage rates can leave people at risk and result in outbreaks and ongoing transmission.
To achieve measles elimination, strong political commitment and sustained investment is needed to ensure all children receive two doses of the measles vaccine and surveillance systems can rapidly detect outbreaks. The IA2030 Mid-Term Review calls on countries and partners to strengthen routine immunization, surveillance and rapid outbreak response capabilities, and to deliver high-quality, high-coverage campaigns when routine immunization is not yet sufficient to protect every child.
Note to editors
WHO uses statistical modelling to estimate measles cases and deaths each year, based on cases reported by countries, and revises the previous year's estimates to assess disease trends over time.
WHO is a founding member of the Measles & Rubella Partnership (M&RP), a global initiative to stop measles and rubella. Under the umbrella of Immunization Agenda 2030 and guided by the Measles and Rubella Strategic Framework 2030, M&RP’s mission includes addressing the decline in national vaccination coverage, hastening the recovery of the measles backsliding resulting from COVID-19 pandemic, and accelerating progress towards creating a world free of measles and rubella. The partnership also includes American Red Cross, the Gates Foundation, Gavi, the Vaccine Alliance, the U.S. Centers for Disease Control and Prevention (CDC), United Nations Foundation, and UNICEF.
Measles elimination is defined as the absence of endemic measles virus transmission in a region or other defined geographical area for more than 12 months. Conversely, a country is no longer considered to be measles free if the virus returns, and transmission is sustained continuously for more than a year.
The Immunization Agenda 2030 global monitoring framework defines large or disruptive outbreaks as having ≥20 cases per one million population in a 12-month period.
