The global threat of measles remains for another year. There is still a high exposure of millions of unvaccinated children to viruses of the paramyxovirus family, the cause of the infection. “The structural problems caused by wars, climate disasters and the lack of access to vaccines prevent the elimination of this infectious disease,” laments Jordi Casabona, epidemiologist and secretary of the STI Group of the Spanish Society of Infectious Diseases and Clinical Microbiology (Seimc). ).

After years of declines in measles vaccination coverage, measles cases in 2022 increased by 18% and deaths increased by 43% globally (compared to 2021). This results in an estimated nine million infections and 136,000 deaths (mostly children), according to a new report from the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). USA.

These two international organizations insist on the public health problem caused by the lack of immunization. “This is a serious and highly contagious infection,” explains its vice president, Pedro Gorrotxategi, from the Spanish Association of Primary Care Pediatrics (AEPap).. “The problem arises when a child, who has not been vaccinated, enters a community where there are gaps in vaccination rates. If there is circulation of the virus, he and those unimmunized minors will generate an outbreak,” recalls Gorrotxategi..

The problem is not only in children, but also “in the vulnerable population,” as Casabona adds.. “Older people, adults in whom the body loses its shield against the virus; in them, it can generate a significant health problem”.

In 2022, 37 countries experienced major measles outbreaks, compared to 22 countries in 2021. Of the countries that experienced outbreaks, 28 were in the WHO African Region, six in the Eastern Mediterranean, two in Southeast Asia and one in the European region..

“The increase in measles outbreaks and deaths is striking, but unfortunately not unexpected given the decline in vaccination rates we have seen in recent years,” said John Vertefeuille, director of the CDC's Division of Global Immunization.. “Measles cases anywhere pose a risk to all countries and communities where people are not sufficiently vaccinated.”. “Urgent and targeted efforts are essential to prevent disease and deaths from measles.”.

It should be noted that in 2017 Spain was declared a country “free of endemic measles transmission” by the WHO, recognizing that the few cases and outbreaks that are identified are a consequence of imports from other countries and not of sustained circulation of the virus in our territory..

In our country, according to the latest report from the Carlos III Health Institute, 49 cases were reported this year, in only nine the infection was confirmed and all but one were imported.. “That is why it is important that every time a child arrives in a new community, from pediatrics we adjust their vaccination schedule to that of their peers.. Only in this way will we all be protected,” says Gorrotxategi..

This is important in the face of migratory movements, “because not all countries have the same access to vaccines and that is the first thing that should be addressed,” Casabona insists.. Furthermore, the Seimc spokesperson emphasizes that in our country after Covid we once again have coverage above 95%, “and these are necessary to ensure that the circulating virus does not impact. That is why it is important to do pedagogy and insist on the benefits of vaccination.”.

The only way to avoid measles is with two doses of the vaccine. In Spain it is regulated and covered by Health in the first years of life. Although, as the international report points out, there was a modest increase in global vaccination coverage in 2022 compared to 2021, there were still 33 million children who missed a dose of the measles vaccine: almost 22 million missed their first doses and another 11 million missed their second dose.

The global vaccination coverage rate for the first dose of 83% and the second dose of 74% was still well below the 95% two-dose coverage needed to protect communities from sprouts. “We must ensure that the rates are higher, because, although it is considered a benign disease, it sometimes has serious consequences,” Casabona replies..

Low-income countries, where the risk of death from measles is highest, continue to have the lowest vaccination rates, at just 66%; a rate that does not show any recovery from the decline during the pandemic. Of the 22 million children who did not receive their first dose of measles vaccine in 2022, more than half live in just 10 countries: Angola, Brazil, Democratic Republic of the Congo, Ethiopia, India, Indonesia, Madagascar, Nigeria, Pakistan and the Philippines.

“The lack of recovery of measles vaccine coverage in low-income countries after the pandemic is a warning signal to act. Measles is called the virus of inequity for good reason. It is the disease will find and attack those who are not protected,” says Kate O'Brien, Director of Immunization, Vaccines and Biologicals at WHO. “Children around the world have the right to be protected by the life-saving measles vaccine, no matter where they live.”

Heat waves, drought, continued exposure to polluted air…. The imprint of the climate crisis on our body is already palpable. Almost half a million deaths are due to particulate matter (PM2.5) emissions associated with the transportation industry. Almost two million annual deaths worldwide result directly from exposure to polluted outdoor air.. Heat-related mortality in people over 65 years of age increased by 85% between 2013 and 2022.

These are figures that appear in the 'iceberg' that contains all the consequences of climate change. Some consequences included in the eighth edition of the Countdown on Health and Climate Change, published by The Lancet magazine.. “Our health analysis reveals that today the growing threats of climate change are claiming lives and affecting people's livelihoods around the world,” said Marina Romanello, executive director of the Lancet Countdown at University College London..

The future that experts paint is not at all hopeful: the world is on track to reach 2.7°C warming by 2100 and energy-related emissions will reach a new record in 2022, the lives of current and future generations hang in the balance of a thread. “With an emission of 1,337 tons of carbon dioxide per second, we are not even close to reducing emissions quickly enough to keep climate dangers within tolerable levels for our health systems,” Romanello insists..

Throughout 2022, people were exposed, on average, to 86 days of extreme temperatures that posed a risk to their health, of which 60% were at least twice as likely to occur due to human-caused climate change.

What does the Lancet Countdown report reflect?

The eighth Lancet Countdown report is the collaborative work of 114 leading experts from 52 research institutions and UN agencies around the world, including the World Health Organization (WHO) and the World Meteorological Organization (WMO).. The report is led by University College London and presents the most up-to-date analysis of the link between health and climate change.

The Lancet Countdown data is released ahead of the 28th United Nations Conference of the Parties (COP) and features 47 indicators including new and improved metrics that track household air pollution, financing to the fossil fuel industry and the participation of international organizations in the health benefits of climate mitigation.

The authors of the report denounce the “negligence” of governments, companies and banks that continue to invest in the oil and gas industry, while the challenges and costs of adaptation increase and the damage caused to the planet approaches a point of no return. They warn that without the implementation of strong and rapid mitigation measures to address the underlying causes of climate change, the health of humanity is in serious danger..

“Projections of a planet with a temperature increase of 2°C speak to a dangerous future, and are a grim reminder that the pace and scale of mitigation efforts we have seen so far have been woefully inadequate to safeguard the health and safety of people,” says Romanello.

Spanish contribution to the report

The Barcelona Supercomputing Center-Centro Nacional de Supercomputación (BSC-CNS) stands out as one of the leading institutes in contributing to the Lancet Countdown reports. Multiple members of the Global Health Resilience team contributed to this report, including Dr. Kim van Daalen (Research Fellow of the Lancet Countdown in Europe), Martín Lotto Batista (author of the malaria indicator), and ICREA professor Rachel Lowe ( director of the Lancet Countdown in Europe).

From the BSC-CNS they explain that “for this year's report, we generated projections until the year 2100, using two climate change scenarios.. “Our results reveal a clear trend of increasing conditions conducive to malaria transmission, especially in high altitude areas, such as the highlands of Ethiopia in Africa or the Andes in South America.”.

Furthermore, they add that “when projecting into the future, we see a shift of these conditions towards the poles as temperatures rise and precipitation patterns undergo changes.”. In addition, our team contributes to the critical analysis of the differential impacts between various regions of the world.”.

Although the Lancet Countdown reports are global, these experts announce that in April 2024 they will publish specific data for the European region.. “Last year we published a specific report on Europe for the first time,” they recall..

So, “we point out that the impact of climate change on health is unequal between regions. For example, southern Europe tends to suffer more from diseases associated with heat waves, forest fires and droughts. Next April, we will publish an update of these results, expanding our monitoring to other health impacts, such as tick-borne diseases and leishmaniasis, among others.”.

What are the most important traces?

In 2023, the planet experienced the highest global temperatures in the last 100,000 years, with all continents breaking their temperature records. Around the world, people were exposed to deadly dangers. And these changes in the climate pattern lead to more pathologies.

Some have heat as the cause. With the current average global warming of 1.14°C over the last decade, people experienced an average of 86 days of extreme temperatures that pose harm to their health in the period 2018-2022. Of these days, more than 60% were at least twice as likely to occur due to human-caused climate change.

Heat-related mortality in people over 65 years of age increased by 85% between 2013 and 2022, compared to the period 1991-2000. This number is well above the 38% increase projected if there were no temperature change (i.e., taking into account only demographic changes)..

More frequent heat waves and droughts were associated with 127 million more people reporting moderate to severe food insecurity in 122 countries in 2021, compared to annually between 1981 and 2010.. This means that around 525 million people would be affected between 2041-2060, which would exacerbate the risk of malnutrition globally..

A health worker mixes fumigation chemicals during a campaign to combat mosquitoes that transmit dengue. EBRAHIM HAMID AFP

“In Europe, as globally, we see an increase in the negative impacts of climate change on human health. This is reflected in an increase in deaths from heat waves, greater exposure to extreme events and changes in the conditions for the transmission of infectious diseases such as West Nile Fever and Vibrio,” the BSC-CNS explains..

Regarding this bacteria, changing weather patterns are accelerating the transmission of deadly infectious diseases. For example, rising ocean temperatures have caused the area of the planet's coasts suitable for the spread of Vibrio, which can cause illness and even death in humans, to increase by 329 km each year since 1982.. This puts a record number at risk: 1.4 billion people could suffer from diarrhea, severe wound infections and sepsis.. In the case of dengue, its transmission potential would increase by 37%, which would result in rapid spread globally..

Others have pollution as their origin. Changing the way we get around and instead offering active, public, electric and accessible alternatives could prevent many of the 460,000 annual deaths caused by diesel particulate emissions..

However, there is one fact that invites hope.. This year's report reveals that deaths associated with air pollution from fossil fuels have decreased by almost 17% since 2005, with 80% of this decrease the result of efforts to reduce pollution from burning coal..

What is the economic impact of all health expenses?

A shocking fact is that the total value of economic losses associated with extreme climate events was estimated at $264 billion in 2022, an increase of 23% compared to the 2010-2014 period..

Extreme temperatures also caused the loss of 490 billion potential working hours globally in 2022 (an increase of almost 42% compared to the period 1991-2000)..

Income declines accounted for a much larger share of GDP in low-income (6.1%) and middle-income countries (3.8%).. Such losses compromise people's livelihoods, thereby limiting countries' ability to cope with and recover from the effects of climate change.. “We are facing one crisis after another,” warns Georgiana Gordon-Strachan, director of the regional center for small island developing states at the Lancet Countdown..

“At a time when the world is on the brink of irreversible damage, the fact that governments and companies continue to invest shamelessly in the oil and gas industry means they are ensuring that the 1.5°C global warming target is met. Paris Agreement is not fulfilled. “This would put the health of millions of people at risk,” said Paul Ekins, head of the Lancet Countdown working group on economics and finance..