Nepal eliminates rubella as a public health problem

The World Health Organization (WHO) has confirmed that Nepal has eliminated rubella as a public health problem. This announcement marks a major achievement for Nepal’s health system and highlights the country’s long-term investment in protecting children and families from preventable diseases.

Rubella, sometimes called German measles, is often a mild illness for children and young adults. Yet its impact can be serious during pregnancy, leading to miscarriage, stillbirth, or lifelong birth defects known as congenital rubella syndrome. By eliminating the disease, Nepal has taken a significant step in improving maternal and child health.

Nepal’s path to rubella elimination

Nepal’s work to eliminate rubella began more than a decade ago. The rubella vaccine was introduced into the national immunization program in 2012, with a large-scale campaign targeting children between 9 months and 15 years. In 2016, the government added a second dose to the routine vaccination schedule, ensuring stronger and longer-lasting protection.

Over the next decade, Nepal carried out several follow-up campaigns in 2016, 2020, and 2024. These campaigns targeted children who may have been missed, closing immunity gaps. By 2024, the country had achieved vaccine coverage of more than 95 percent for at least one dose—well above the level needed to stop community transmission.

The effort was not without obstacles. The 2015 and 2023 earthquakes disrupted health services, and the COVID-19 pandemic strained already limited resources. But health workers, volunteers, and communities kept immunization efforts moving forward. Their persistence ensured that progress continued, even during difficult years.

Strategies that made the difference

High vaccine coverage was the foundation of Nepal’s success, but several specific strategies strengthened the overall campaign:

• National Immunization Months. Regular awareness drives reminded parents and caregivers about vaccination.
• Reaching the unreached. Special efforts focused on children who had been missed in earlier campaigns.
• Local accountability. Districts were recognized for achieving “fully immunized” status, encouraging stronger local leadership.
• Improved surveillance. Nepal introduced a new laboratory testing system, the first of its kind in the region, which made it easier to confirm cases and respond quickly to outbreaks.

These steps ensured that elimination was not just a one-time achievement but something that could be sustained.

Regional and global context

Nepal is now the sixth country in the WHO South-East Asia Region to eliminate rubella, joining Bhutan, the Maldives, Sri Lanka, Timor-Leste, and the Democratic People’s Republic of Korea.

The region had originally set a goal of controlling rubella by 2020, then updated it in 2019 to eliminate both measles and rubella by 2023. The COVID-19 pandemic disrupted timelines, pushing the target to 2026. Nepal’s early success shows what can be achieved despite such challenges.

Globally, rubella cases have dropped dramatically, from more than 670,000 in 2000 to fewer than 18,000 in 2022, according to WHO data. Nepal’s progress contributes to this broader global trend of reducing vaccine-preventable diseases.

Recognition from leaders

The achievement has been recognized both nationally and internationally.

• Dr. Catharina Boehme, WHO Officer-in-Charge for the region, described the result as a reflection of “unwavering commitment from leadership, health workers, and communities.”
• Health Minister Pradip Paudel said elimination shows the strength of Nepal’s immunization system and thanked partners like Gavi, the Vaccine Alliance and WHO for their support.
• Dr. Rajesh Sambhajirao Pandav, WHO’s representative in Nepal, highlighted the importance of collaboration in achieving and sustaining rubella elimination.

Sustaining success in the future

Eliminating rubella does not mean the virus has disappeared entirely. It means that sustained transmission has been interrupted for at least three years, backed by strong vaccine coverage and surveillance. To maintain this status, Nepal must:

• Keep vaccine coverage high through routine immunization,
• Reach children in hard-to-access communities, and
• Continue strong disease monitoring and laboratory testing.

The risk of resurgence remains if coverage drops. Continued political commitment and investment will be essential to prevent rubella from returning.

Why this matters

Rubella elimination has immediate benefits for mothers, babies, and families. It reduces pregnancy risks, prevents lifelong disability, and lowers the social and financial burden on families and the health system.

Just as important, Nepal’s achievement demonstrates what is possible for countries facing significant challenges. By combining political will, grassroots mobilization, and global partnerships, even nations with limited resources can make historic progress in public health.

Conclusion

Nepal’s elimination of rubella is a milestone worth recognizing. It shows what can be accomplished with sustained effort, innovation, and commitment. The country’s success provides hope for other nations still working toward this goal—and for the broader global effort to end vaccine-preventable diseases.

As Nepal looks to the future, its task will be to sustain this achievement. For the world, Nepal’s story is a reminder that progress is possible, even against persistent challenges.