Progress towards measles and rubella elimination in Eswatini by 2024.

Eswatini has been implementing measles and rubella elimination strategies, aligning with the WHO African Regional goal. This report reviews the immunization coverage and surveillance data to evaluate the country's progress towards the elimination goals. We reviewed routine immunisation coverage data, supplemental immunisation activity coverage data, and case based and laboratory surveillance data for measles and rubella. Routine immunization coverage for the first and second dose was 85% and 82% respectively in 2023 according to the WHO UNICEF coverage estimates. Eswatini implemented regular nationwide preventive supplemental immunisation activities, with the most recent one in 2021 attaining 97% administrative coverage. Eswatini has consistently met the performance targets for the principal indicators since 2008. The incidence of both measles and rubella have been maintained at less than 5 cases per million for more than 10 years, with zero incidence of measles documented over multiple years. Eswatini has made immense progress towards measles and rubella elimination. The country will need to address programmatic gaps that may negatively impact population immunity and will need to maintain high quality measles and rubella surveillance, including molecular surveillance in order to attain and maintain the verification of measles and rubella elimination.