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The World Health Organization (WHO) has officially announced that Nepal has eliminated rubella as a public health problem, marking a significant achievement in the country’s fight against vaccine-preventable diseases. Nepal is the sixth country in the WHO South-East Asia Region to achieve rubella elimination, joining Bhutan, DPR Korea, Maldives, Sri Lanka, and Timor-Leste.

About Rubella

• Rubella, also known as German measles or three-day measles, is a highly contagious viral infection caused by the Rubella virus, an enveloped, single-stranded RNA virus distinct from the measles virus.
• Rubella primarily spreads through coughing, sneezing, or contact with contaminated surfaces, and can also be transmitted from a pregnant woman to her fetus.
• While rubella generally causes mild or no symptoms, the hallmark is a spotty red rash starting on the face or behind the ears and spreading to the neck and body.
• Infection during early pregnancy is particularly dangerous, with a 90% chance of virus transmission to the fetus, potentially causing miscarriage, stillbirth, or Congenital Rubella Syndrome (CRS). CRS may result in hearing impairments, eye and heart defects, and lifelong disabilities, including autism, diabetes, and thyroid dysfunction.
• Currently, there is no specific treatment for rubella, and symptoms are generally managed with rest and fever-reducing medications. Prevention through vaccination is key: the measles-mumps-rubella (MMR) vaccine is safe, highly effective, and provides lifelong protection.

Nepal’s Rubella Elimination Journey

• Nepal introduced the rubella-containing vaccine in its immunization program in 2012, targeting children aged 9 months to 15 years. A second dose was added to the routine immunization schedule in 2016.
• Nationwide campaigns in 2012, 2016, 2020, and 2024 helped achieve over 95% coverage for at least one dose, despite challenges such as the COVID-19 pandemic and earthquakes in 2015 and 2023.
• The country implemented innovative strategies such as observing an “immunization month,” outreach programs for missed children, and incentives for districts to achieve “fully immunized” status. Nepal also strengthened rubella surveillance through a robust laboratory testing algorithm, the first of its kind in the WHO South-East Asia Region.

Regional and Global Recognition

The Regional Verification Commission for Measles and Rubella (SEA-RVC), established in 2016, reviewed data from Nepal’s National Verification Committee and recommended verification of rubella elimination. Nepal’s Ministry of Health and Population acknowledged the contribution of government leadership, health workers, volunteers, and communities, alongside support from WHO and Gavi, in achieving this milestone.

The WHO South-East Asia Region initially aimed to eliminate measles and control rubella by 2020, later revising the target to 2023, and finally extending to 2026 due to setbacks caused by the COVID-19 pandemic. Nepal’s early achievement underscores the strength of its national immunization program and serves as a model for other countries in the region.