- Thailand has achieved rubella elimination as a public health problem, becoming the seventh country in the WHO South-East Asia Region to reach this goal.
- India has made strong progress in MR vaccination and reducing measles and rubella cases, but remains endemic and needs stronger district-level coverage and surveillance.
- Thailand’s success shows that sustained immunisation, effective surveillance, community outreach and long-term commitment are essential for India to achieve elimination.
The World Health Organisation has, on 5 September 2026, certified that Thailand has achieved elimination of rubella as a public health problem, making Thailand the seventh country in the South-East Asia region of the WHO to achieve this goal. This certification has been granted following an assessment of the country’s data on rubella surveillance, laboratories, and immunisation carried out by the Regional Verification Commission in June 2026, along with an on-the-ground inspection in July 2026. It has come quietly, after several years of hard, often tedious efforts. But for India, which is considered endemic for rubella, this news is more of a reflection than a neighbouring story. What does it take for India to reach this goal?
Rubella is generally harmless, but the threat from the virus is what it does to a developing fetus, which may result in miscarriage, stillbirth, or congenital rubella syndrome (CRS), which entails birth defects such as hearing loss, sight problems, and heart defects. It follows that rubella prevention is essentially about maternal and child health.
It is important to be exact on definitions: “elimination” is interruption of endemic (sustained local) transmission for a certain period, not the end of rubella forever because it can still enter the country (imported cases). It is different from “eradication,” which involves reduction of the disease permanently to zero on a global level, something achieved only in the case of smallpox.
The unglamorous work behind Thailand’s success
This is not the history of Thailand since the beginning of this year. The Expanded Program on Immunisation of Thailand began way back in 1977; a rubella vaccine was provided to six-year-old schoolgirls in 1986 and extended to all one-year-olds in 1993. The result was decades of routine immunisation viewed as basic infrastructure, national-provincial coordination, focused efforts on reaching the disadvantaged and mobile communities, and fever-and-rash surveillance for identifying suspected cases for quick lab verification.
Nationwide figures may be deceiving; they appear reassuring but may hide the groups of children not vaccinated in certain districts — that’s precisely where the outbreaks and cases of CRS originate from. “Resilient immunisation services, high-quality surveillance and community trust” were the elements that combined into a system designed to identify cases early.
Where India stands
The position of India is a mixture of success and an incomplete agenda rather than failure. Two free doses of MR vaccine have been provided to infants between 9-12 and 16-24 months through the Universal Immunisation Program. National coverage was 93.7% and 92.2% respectively in 2024-25 figures for the first and second doses. Measles and rubella cases were reduced by 73% and 17%, respectively, from 2023, and in Jan-Mar 2025, 332 and 487 districts had zero cases of measles and rubella, respectively.
In the case of India, the situation is one of a success story and an unfinished agenda as opposed to failure. Free vaccines for MR have been administered to children aged between 9-12 and 16-24 months via the Universal Immunisation Program. The national coverage rate stood at 93.7% and 92.2% in 2024-25 for the first and second doses, respectively. The number of cases for measles and rubella fell by 73% and 17% in 2023, while in Jan-Mar 2025, 332 and 487 districts recorded no cases of measles and rubella, respectively.
However, India continues to be considered endemic for both conditions based on the latest evaluation of the WHO Regional Verification Commission. The 95% target of two-dose vaccine coverage at the district level remains unmet by the Indian government across the country. It is the difference between the national average and 95%+ coverage at all of India’s 780 districts that dictates success or failure in stopping disease transmission chains. In April 2025, the “National Zero Measles-Rubella Elimination Campaign 2025-26” campaign was launched in India to aim for 100% coverage, improve district surveillance through IDSP, and identify missing children using U-WIN (Ministry of Health and Family Welfare, 2025).
What India can learn — without copying Thailand’s playbook
India’s healthcare system works on a larger scale than that of Thailand. This does not mean it serves as a model for others to follow but rather provides important concepts that need to be implemented: high level of immunity, efficient monitoring, prompt action, accountability and perseverance.
Forget about general statistics. Behind the 93.7% statistic lie groups of unvaccinated children in particular areas, which are the source of epidemics.
Focus on immunisation in general rather than immunisation campaigns only. It is stated explicitly in India’s own immunisation strategy that the main goal should be a sustained coverage rate of more than 95%.
Enhance case-based, laboratory-confirmed surveillance nationally, with fever-and-rash cases identified early — an area where IDSP can excel, but which needs to be applied everywhere with the same diligence.
Target mobile and migrant populations deliberately, and maintain political interest over years, not just one election cycle — Thailand’s program is almost five decades old now.
Where CSR can genuinely add value
Corporate social responsibility funding can never replace the government’s responsibility for organising vaccination delivery through procurement, cold chain management, and the UIP. There is certainly a lot that can be done through CSR to complement the efforts being made by the government, including raising vaccine confidence by fighting misinformation; reaching out to migrant labour camps and slums, which traditional health systems often fail to reach; training community healthcare workers; independent monitoring of areas where coverage is inadequate; and learning from successful district-level models.
The road ahead
This is a feat that has been proven to be possible in the region through a combination of high immunisation rates, rigorous monitoring and political will, but not just one of these things alone. India has taken big strides in the right direction through coverage of over 90%, reduction in measles cases by almost 75% in a year and a program based on the same strategies used to bring Thailand to this point.
Clear Cut Health Desk
New Delhi, UPDATED: September 08, 2026 09:30 IST
Written By: Dr. Jyoti Aggarwal
Designation: Senior Research Associate at Devinsights
