Sustaining measles elimination: Vanuatu puts preparedness to the test

Port Vila, Vanuatu – Pacific island countries achieved the milestone of measles and rubella elimination in 2025, and now Vanuatu is moving quickly to safeguard those hard-earned gains.

On 2 June 2026, the Ministry of Health, supported by WHO, brought together national and provincial health leaders to test how ready the country is to respond if measles returns. 

Using a national simulation exercise (SIMEX), health teams worked through a realistic outbreak scenario designed to reflect the real-world risks posed by imported measles cases, test existing processes, identify areas for improvement, and strengthen national outbreak readiness.

Preparedness is the frontline of health protection

Global measles outbreaks and the ease of travel across Pacific island countries mean that a single imported case can quickly escalate if health systems are not ready. In this context, preparedness is the frontline of protection. 

Better preparedness means that when an outbreak happens, countries can respond faster, coordinate more effectively, and protect communities.

Preparedness at this level is essential. While measles has been eliminated in the Pacific, the threat has not disappeared.

Participant Wendy Williams, Manager of Surveillance, noted that "this simulation exercise has strengthened our capacity to detect and respond to measles outbreaks through improved surveillance, data-driven decision-making, and coordinated emergency response. The lessons identified will directly inform priority actions to enhance early warning systems and ensure a timely and effective response to future outbreaks." 

Simulations prepare teams for when an outbreak happens

The SIMEX began by alerting teams to an imported measles case. This initial case escalated to community transmission and spread to outer islands – challenging participants to act fast, coordinate effectively, and make decisions under pressure. 

The exercise tested the full spectrum of outbreak response, including assessing surveillance and early warning systems, laboratory referrals and sample management, and the activation of rapid response teams.

Working through the complexities of contact tracing, vaccination response planning, and infection prevention and control, participants also navigated risk communication, media management, and cross-sector coordination at both national and provincial levels. 

"This exercise is an important milestone in strengthening Vanuatu's capacity to prevent and respond to measles outbreaks through coordinated planning and continuous improvement,” said National VDI Coordinator Simon Samson.

^{Health promotion team and WHO in discussion. © Jeffrey Ditingco}

Vanuatu has strong emergency preparedness foundations to build on

Some of the key strengths of Vanuatu’s current system were: 

• Surveillance capacity: health teams have a clear understanding of measles case definitions and notification procedures.
• Readiness to activate response mechanisms: there is a shared appreciation that speed and a clear understanding of the roles and responsibilities of immunization teams, surveillance officers, laboratory services, provincial health leaders and partners are critical to containing outbreaks. 
• Vaccination support: vaccines are seen as the most effective tool for controlling transmission, reinforcing their central role in protecting communities. 
• Strengthened collaboration and engagement: the exercise promoted coordination across the health system with Ministry of Health and partners, including WHO, reinforcing the collaborative efforts required to maintain elimination. 

Turning learnings into strengths for the future

Crucially, the SIMEX did not end with observations; it resulted in key recommendations and actions to be implemented in the coming months to strengthen vaccination, incident management, laboratory preparedness, infection prevention and control, as well as risk communication and community engagement. The key recommendations and actions include:

• operationalizing the national measles outbreak preparedness and response plan 
• improve the vaccination coverage for both doses 
• strengthening surveillance sensitivity 
• improving laboratory referral systems 
• ensuring logistics readiness 
• updating emergency communication systems 
• conducting regular simulation and reviews of preparedness to maintain readiness over time. 

^{Discussions during the simulation exercise. © Jeffrey Ditingco}

Simulation exercises are practical tools that save lives

For Vanuatu, achieving measles elimination in the Pacific is a major milestone, but sustaining it requires constant vigilance, strong systems and continued investment in preparedness. 

The lessons learned through the SIMEX provide a clear roadmap for sustaining measles elimination in Vanuatu and contribute to maintaining elimination across the greater Pacific. Because when it comes to measles, what happens before an outbreak begins is what makes all the difference. 

“Elimination does not mean the risk is gone. It means we must stay ready. This exercise is about making sure Vanuatu can respond quickly and effectively to protect our people if measles returns,” said WHO Country Liaison Officer Dr Revite Kirition.

Acknowledgements

The World Health Organization (WHO) provides technical support to the Vanuatu Ministry of Health through its WHO Country Liaison Office for Vanuatu, in collaboration with the WHO Division of Pacific Technical Support and the WHO South Pacific office. This work was made possible through the generous funding of the Australian Government, provided via the Department of Foreign Affairs and Trade.