Category World News

After nearly 30 years, Canada has lost its measles “elimination” status, which, by default, has caused the overall Americas region to lose its status as well.

In a statement issued on Monday, the country’s Public Health Agency stated that Canada was experiencing a “large, multi-jurisdictional outbreak of measles” which began in October last year.

Over the past year, the agency has recorded cases in Alberta, British Columbia, Manitoba, New Brunswick, Nova Scotia, Ontario, Prince Edward Island, Quebec, Saskatchewan and the Northwest Territories. Overall, 5,000 positive cases of the illness and the deaths of two premature babies have been reported.

“Canada can re-establish its measles elimination status once transmission of the measles strain associated with the current outbreak is interrupted for at least 12 months,” the agency said.

Here’s what we know about the loss of the elimination status:

What is measles?

It is a highly infectious virus which can be life-threatening if not caught early.

The illness, which is spread through the air when an infected person coughs or sneezes, begins with cold-like symptoms, including a runny nose, high temperature and sore, red eyes.

A few days after infection, small white spots can appear inside the cheeks and on the back of the lips. A rash then begins on the face and behind the ears before spreading across the body – the main telltale sign of the illness, according to information from NHS England.

In the worst-case scenario, measles can cause pneumonia and become life-threatening. Babies and anyone with a weakened immune system are most at risk.

Measles is widely prevented through the use of the MMR (measles, mumps and rubella) vaccine, which is administered in two doses to children at one year old and three years old.

According to the US Centres for Disease Control and Prevention (CDC), two doses of the vaccine are 97 percent effective in preventing a measles infection.

Why has Canada lost its measles status?

The “elimination” designation, which Canada has had since 1998, indicates that no locally transmitted infections or outbreaks have been reported in the past 12 months. This is no longer the case.

Mark Joffe, Alberta’s chief medical officer until earlier this year, blamed low take-up of vaccinations and told the Reuters news agency last month that more could have been done in the country to boost immunisation rates.

“If the vaccination rates were high, this would never have happened. There may have been [some spread], but nothing like this,” Joffe said.

Why are vaccination rates falling?

According to the WHO and the US CDC, the main reason measles is spreading is that fewer people are taking up vaccines across the Americas region generally.

One contributing factor for low vaccination rates is a growing distrust of healthcare providers following the COVID-19 pandemic, in which anti-vaccine misinformation spread.

One of the most persistent myths driving MMR vaccine hesitancy is the claim that it causes autism. This belief stems from a 1998 study, which has since been discredited and retracted. There is no scientific evidence of any link between the MMR vaccine and autism.

In some US states and Canadian provinces, exemptions for vaccine mandates – giving non-medical reasons for declining vaccines, such as for personal or religious reasons – are becoming more common. This has led to the existence of clusters of unvaccinated people who are more vulnerable to outbreaks when exposed to the virus.

Some communities, such as the Mennonites – Anabaptist Christians who have communities in the US, Canada and Mexico – have low vaccination rates, as conservative branches of the community do not believe in modern medicine. Several outbreaks in the past year have been traced to Mennonite communities.

Overall in Canada, according to public health data, measles immunisation also fell during the onset of the COVID-19 pandemic, when lockdowns made it harder to access general healthcare, and continued afterwards.

In 2019, 89.5 percent of children in Canada received their first dose of the MMR vaccine. But by 2023, that figure had dropped to 82.5 percent.

In the US, during the 2024-2025 school year, 92.7 percent of children received the vaccine, according to the CDC.

In Mexico, according to WHO figures, 79.86 percent of children received the first dose of the MMR vaccine.

At least 95 percent of a population is required to be vaccinated in order to achieve “herd immunity” against measles. Herd immunity means enough people have been vaccinated to make it too hard for the disease to spread.

Experts say the safest way to maintain herd immunity is through vaccination programmes.

How effective is the measles vaccine?

According to the World Health Organization (WHO), measles vaccination prevented an estimated 31.7 million deaths globally between 2000 and 2020.

The MMR vaccine, widely used around the world, provides about 97 percent protection against the measles virus, according to public health agencies.

The vaccine is normally given to children in two stages: The first dose at 12 months and the second at about three years and four months of age (when the child is nearing pre-school age), as part of routine immunisation programmes in countries like the United Kingdom.

Breakthrough cases in vaccinated people are rare and usually mild.

How has the wider Americas region been affected?

According to the Pan American Health Organisation (PAHO), part of the wider World Health Organization, Canada’s loss of its status means that “the Region of the Americas has lost its verification as free from endemic measles transmission”.

Once the MMR vaccine was approved for distribution in 1963, healthcare practitioners and school programmes were initiated in Canada, pushing for families to receive immunisation.

By 1998, Canada had achieved its measles elimination status. Two years later, the US achieved its elimination status, as well.

By 2016, the Americas region was declared free from measles, which meant that every country in the region had reached elimination status.

Following an outbreak in Venezuela and Brazil in 2018, the Americas lost its regional elimination status, only to have it reinstated last year once the outbreak was brought under control.

Now, the Americas region has lost its elimination status once again because of the Canadian outbreak. While many individual countries within the region still have their elimination status, measles cases are on the rise, generally.

As of November 7, the PAHO said, there were 12,596 cases of measles across the region, with about 95 percent reported in Canada, Mexico and the United States.

The PAHO said this was a “30-fold increase compared to 2024″.

Twenty-eight deaths have been recorded: 23 in Mexico, three in the United States, and two in Canada.

Jarbas Barbosa, director of PAHO, said the region’s loss of its elimination status was a “setback – but it is also reversible”.

“Until measles is eliminated worldwide, our region will continue to face the risk of reintroduction and spread of the virus among unvaccinated or under-vaccinated populations. However, as we have demonstrated before, with political commitment, regional cooperation, and sustained vaccination, the region can once again interrupt transmission and reclaim this collective achievement,” Barbosa said.

Which other countries in the region are at risk of losing their elimination status?

Currently, active outbreaks are occurring in Mexico, the US, Bolivia, Brazil, Paraguay and Belize, which have been “mostly triggered by imported cases”, according to PAHO.

Mexico

Mexico had reported 5,019 measles cases by October 31, according to data from PAHO. The cases are concentrated in the northern state of Chihuahua.

Just seven cases were reported in the whole of Mexico last year. A 31-year-old unvaccinated man from Ascension, Chihuahua, died from the disease in early April this year and at least 14 deaths have been reported since then, according to PAHO.

US

In the US, since January, a measles outbreak has led to 1,681 confirmed cases, according to the CDC last week.

In February, it reported its first measles death in a decade after an unvaccinated child fell ill amid an outbreak in Texas. The school-aged child died overnight after being hospitalised in Lubbock, northwest Texas, the state’s health department said.

Of those who have tested positive for the disease, 92 percent were unvaccinated or had unknown vaccination status.

Demetre Daskalakis, a former CDC official, told Reuters that the US has a deadline of January 20 to prove that it has curbed the outbreak if it is to retain its elimination status.

Are measles cases on the rise in other parts of the world?

Yes. In late 2023 and early 2024, there was a surge in measles cases in the UK, particularly in England.

In 2024 as a whole, there were 2,911 laboratory-confirmed measles cases in England, the highest number of cases recorded in a year, since 2012, according to the UK Health Security Agency.

In comparison, there were only two confirmed cases of measles across the whole of the UK in 2021 and 54 one year later.

There was another surge in cases in April 2025 – particularly in London and the northwest of the country – the agency said, but cases have since been declining. In 2025 so far, there have been 811 confirmed measles cases in England.

The Arab Gulf states have for decades looked externally for their security, particularly to the West.

The United States, United Kingdom and France have bases throughout the region, underscoring the Gulf’s importance to the West. But the sense of security these bases provide is not as solid as it once was.

In the US, a growing segment of the foreign policy sphere views East Asia as more important to Washington, largely because of the rise of China as a threat to American hegemony.

Analysts who argue that the West is no longer a reliable protector for the Gulf point to evidence such as the September attack on Doha by Israel, which continues to receive US support despite Washington’s attempt to distance itself from the strike.

The uncertainty seems to have prompted Gulf Cooperation Council (GCC) member states to consider other options for their security with perhaps the most notable recent example being the defence pact signed by Saudi Arabia and Pakistan last month.

Pakistan and Saudi Arabia have continued to strengthen ties, including a visit to the latter by Pakistani Prime Minister Shehbaz Sharif on October 27, in which a wide-ranging economic framework was signed.

The GCC and collective security

Collective security in the GCC can be achieved through two separate but related concepts: “collective management” and “endogenous security”.

Collective management in the context of GCC security would include large regional powers, such as Egypt, Pakistan and Turkiye, forming an alliance that would have a shared interest in providing security to countries in the wider Islamic world.

Egypt has the strongest and largest Arab army, and after the attack on Qatar, its president, Abdel-Fattah el-Sisi, proposed a force that could intervene if any Arab country is attacked, offering 20,000 military personnel.

Pakistan is the only Muslim country with nuclear deterrence, and Defence Minister Khawaja Asif has not ruled out the possibility of other Arab countries joining the agreement between Pakistan and Saudi Arabia.

Turkiye is a NATO member with Western military standards and modern weaponry and does not shy away from taking positions that are supportive of other Muslim-majority countries.

Previous iterations of these alliances have historically fallen short of their goals, such as the Middle East Strategic Alliance, proposed during the first administration of US President Donald Trump to stand against Iran and its allied forces but which proved ineffective.

That was partly a result of its focus on Iran, even as many regional countries were moving away from viewing Iran as an immediate threat, unlike the US view of Tehran.

The second form of security is endogenous security, based on shared defence structures among GCC members, who have signed numerous regional security and defence pacts.

These include the formation of a unified army named the Peninsula Shield Force (PSF) in 1984, the Joint Defence Agreement (JDA) in 2000 – modelled on NATO’s Article 5 and committing to collective defence – and finally the Unified Military Command in 2013, which aimed for a more integrated and centralised command structure.

Although these unions somewhat strengthened the sense of collective security among members, they did not change the fact that individual countries had longstanding reliance on external guarantors, sovereignty concerns and divergent responses to regional conflicts.

The PSF was virtually useless during the 1990 invasion of Kuwait because it had only a brigade-sized force (roughly 5,000 soldiers) at the time and was caught off guard by the scale and speed of the Iraqi invasion. The JDA only convened an emergency meeting during the Israeli attack on Doha, reiterating the indivisibility of member states’ security. The goal of the JDA is collective action against an aggressor force like NATO. It should have achieved this aim through more comprehensive mechanisms or coalitions with other military alliances, but it lacked this capability.

These incidents underline that what exists is a joint military command structure with little cohesion, based on mutual defence agreements that are hard to enforce.

The presence of US forces and reliance on US arms supplies limit the GCC’s ability for independent action. Furthermore, the militaries of these countries lack extensive combat experience compared with other regional armies like those of Egypt and Turkiye.

There remain, however, five key areas the GCC could cooperate in: logistics and supply chains, technological innovation, defence industrial management and production, intelligence sharing, and air and missile defence.

It remains to be seen how the GCC will manage such coalitions alongside the presence of external powers and what path it will take towards achieving collective security.

Saudi Arabia’s diversification

On September 17, Saudi Arabia and Pakistan signed a Strategic Mutual Defence Agreement (SMDA), stipulating that aggression against one would be considered aggression against both, a clause reminiscent of Article 5 of NATO’s North Atlantic Treaty.

The deal diversified Saudi Arabia’s security guarantees, reduced its dependence on the US and underlined its autonomy on defence arrangements outside the Western mandate, giving it a balance between the power poles of the US, China and the region.

Although China avoids formal military alliances in the Middle East, it would be happy to see its rival Washington constrained. China has close ties with Pakistan, and a more formal Saudi presence in Pakistan would be welcomed by Beijing.

China has invested billions of dollars in infrastructure and energy projects under the China-Pakistan Economic Corridor (CPEC) and is Pakistan’s largest trading partner with bilateral trade of more than $25bn annually. China also accounts for 81 percent of Pakistan’s arms imports.

However, the US presence in the Middle East is massive and longstanding. It has 19 bases in the region, led an international coalition to liberate Kuwait in 1991 and protects commercial shipping in the Gulf – as well as leading the 2003 invasion and subsequent occupation of Iraq and decades-long support for Israel.

On the other hand, Pakistan has its own conflicts with India and Afghanistan, giving it limited capacity for effective involvement in Middle Eastern crises, despite the mutual defence clause.

Therefore, while this pact diversifies Riyadh’s security options, it is not yet capable of redefining its traditional security dependencies.

Tangible achievements

But the agreement still represents a novel, non-Western approach to regional security, entrusting the resolution of security complexities to the regional countries themselves.

It also allows these countries to benefit from each other’s assets and resources. Through cooperation with Pakistan’s defence industries, Saudi Arabia seeks to realise its ambitious Vision 2030 goals, which include localising 50 percent of its defence needs within the next five years and joining the ranks of the world’s top 25 arms-exporting countries.

Pakistan has made huge progress in its missile industry with its Shaheen-3 missile reaching a range of 2,750km (1,709 miles), even raising concerns about the possible production of intercontinental ballistic missiles capable of hitting targets as far as the US.

Saudi Arabia has previously cooperated with China in this field and can now invest in drone and missile industries with Pakistan, giving it a deterrent against Iranian missile threats.

Pakistani engineers and institutions, such as the Heavy Industries Taxila and the Pakistan Aeronautical Complex, have the expertise to build, maintain and repair drones, aircraft and aviation equipment.

Saudi Arabia could benefit from cooperation with them by providing generous funding that could eventually benefit civilian sectors such as aerospace, artificial intelligence, robotics, cybersecurity and electronics.

Despite such collaborations appearing straightforward at first glance, they face operational challenges.

Defence cooperation and the establishment of joint military industries require the coordination and integration of defence standards. Saudi Arabia’s defence system is Western in nature and deeply dependent on American hardware, intelligence and support networks whereas Pakistani technologies – though cost-effective – are generally at a lower level of technical complexity compared with their Western counterparts, which could complicate mutual cooperation.

Moreover, bureaucracies in the two countries operate at different speeds. Riyadh’s reform agenda is centralised and capital-intensive while Pakistan’s defence sector remains heavily state-controlled and faces budget shortages.

Therefore, cooperation in joint military production, in addition to standardising protocols, requires overcoming administrative and cultural challenges.

The new Saudi-Pakistan defence pact and broader discussions around collective management and endogenous security in the Gulf illustrate that the region is at an inflexion point.

The longstanding dependence on Western protection is being reassessed, not through abrupt abandonment but through diversifying security guarantees. The shift does not yet signal a wholesale decoupling from the US but instead a recalibration with Gulf capitals testing the viability of parallel security arrangements.

The Saudi-Pakistan agreement reflects a willingness to engage new partners and reimagine security as something not just provided by Western powers but jointly constructed by regional actors.

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