by Dr Hany Ragab, PhD student at Liverpool School of Tropical Medicine researching vaccine uptake, health equity, and the systems and relational levers that shape vaccine confidence and responses to health misinformation. He is also a paediatric consultant in Liverpool with clinical and global health experience, including work in Sierra Leone, and has published on child health and quality of care in low-resource settings.
As a paediatric doctor, I’ve seen first-hand what measles resurgence looks like when it stops being an abstract public health concept and becomes a child in front of you. During a UK outbreak in 2025, that reality was underscored by the tragic death of a child reported in the region. Earlier in my career in Sierra Leone, I witnessed how interruptions to vaccination programmes led to widespread measles illness and preventable deaths. I never expected to be drawing on those same experiences to explain events unfolding again in the UK.
This WHO decision matters because measles ‘elimination’ has never meant zero cases; it means a collective ability to break chains of transmission. When that ability is lost, it tells us something deeper has fractured. Re-established transmission does not arise from a single mistake, but from a web of interacting pressures—declining MMR coverage, health access barriers, widening social and economic inequality, and an information environment where doubt travels faster than reassurance. These forces reinforce one another, quietly widening immunity gaps until the virus finds them.
Re-achieving elimination is still possible, but it will not come from slogans or short-term campaigns. It requires sustained investment in public health, making vaccination the easiest default choice, and restoring trust through consistent, face-to-face conversations between families and healthcare professionals. Measles is a disease we know how to prevent; when it returns, it is not because the science has failed, but because our systems—and our social contract around protecting children—have been allowed to weaken.