Measles is like a fire that spreads incredibly fast. It's one of the most contagious diseases.
And the last thing you'd want to do in a fire scenario is get rid of smoke detectors, says Jennifer Nuzzo, director of Brown University's Pandemic Center. But, she says, that's exactly what's happening now, just as measles cases rise in the U.S. and other countries.
She's talking about the U.S. decision to stop funding the Global Measles and Rubella Laboratory Network.
"It's our surveillance infrastructure. You can think of it like the smoke detectors that tell us where the fires are, so that we know how to respond to it," says Nuzzo. "So this is obviously devastating and it's particularly devastating given how many countries are struggling with measles [outbreaks]."
The laboratory network is made up of over 700 laboratories in over 150 countries. The network is run by the World Health Organization but was funded by the U.S. Centers for Disease Control and Prevention since its conception 25 years ago. As part of President Trump's decision to withdraw from the WHO, his administration also cut funding for this lab network, which now "faces imminent shutdown," says Tedros Adhanom Ghebreyesus, the director general of the WHO.
This move comes at a time when the U.S. is seeing a large outbreak of measles in Texas and New Mexico, with roughly 300 confirmed cases and the death of a school-aged child — the first measles fatality in the U.S. in a decade.
And there are big outbreaks elsewhere. For example, there's a growing outbreak in Canada. In Europe, measles cases surged in 2024 to 125,00, their highest level in 25 years, according to a new report from WHO and UNICEF, the U.N.'s children agency. Democratic Republic of Congo has also been hard hit, where there were more than 300,000 measles cases in 2023. That outbreak continues.
"Measles is growing [in Africa]," says Dr. Jean Kaseya, director general of Africa Centers for Disease and Prevention. "We see for children [a] main cause of mortality remains measles …. We need to protect these children."
The global laboratory network, which goes by the acronym GMRLN, has served a key role in identifying measles cases — since the classic fever and rash symptoms can be confused clinically with other diseases like scarlet fever or roseola. With a blood sample, the labs can determine and track the strain of measles to understand how the virus is moving and if it is evolving. The work of GMRLN also helps kickstart an early outbreak response, which often means a vaccination campaign in the impacted community.
"This lab network is now under severe threat of collapse," says Dr. Kate O'Brien, director of the Department of Immunization, Vaccines and Biologicals at WHO. Their work of the lab network — mobilizing epidemiologists, scientists and public health workers who respond to cases — is particularly vital at a time when measles is on the rise, she says. "We will certainly see many, many more outbreaks, many, many more deaths and many, many more cases."
Asked about the cutoff of U.S. funding for the global network, a spokesperson for the U.S. Centers for Disease Control and Prevention said in an email to NPR that the cuts are in line with President Trump's executive order to withdraw from WHO and noted that "funding to support CDC's domestic measles and rubella labs and providing essential laboratory supplies is still ongoing." The spokesperson said the U.S. is not helping support measles labs in other countries.
Who will foot the bill?
O'Brien says WHO is looking for other countries or organizations that could fund the lab network. The price tag: $8 million annually.
"That's a huge amount of money for an individual," she acknowledges. "But when we're talking about protecting the world [from measles] ... $8 million is an incredible deal."
A spokesperson for WHO explained that the overall budget is relatively low because some labs in high-income countries provide their own infrastructure and staff.
Even countries that don't rely on the lab to diagnose domestic cases find it helpful. Dr. Şiran Keske, a professor of infectious diseases at Koc University in Turkey, says that the WHO network helps them monitor measles in neighboring Syria and Iraq. "It's very useful," he says. "We are understanding what's going on around us."
That kind of global knowledge is also useful in the U.S., says Dr. William Moss, a professor at the Johns Hopkins Bloomberg School of Public Health and the executive director of the International Vaccine Access Center. If an outbreak is not detected and contained in the country where it originates, it is more likely to spread to America.
He explains that the measles virus no longer circulates naturally in the U.S. — "so all measles outbreaks in the United States are starting with importations from outside." For example, a measles case in Maryland earlier this month was in someone who had travelled internationally.
Nuzzo says the $8 million price tag is a great financial deal for the U.S. because outbreaks are not only damaging to the impacted community and deadly but also expensive. "The amount of resources it requires to control measles outbreaks is extraordinary," she says, including the cost of emergency vaccination campaigns, hospitalization, diverting resources from other public health initiatives and, ultimately, death.
The U.S. move to cut funding to the lab network is part of a broader trend by the Trump administration to abruptly step back from global health initiatives, says Dr. Tom Frieden, former CDC Director and president and CEO of Resolve to Save Lives.
"When you stop things suddenly, bad things happen," he says.
And, he adds, it's not just measles outbreaks that could be impacted. The laboratory network is designed to pivot to other diseases – including Ebola and avian flu as well as new pathogens – when there's a health need.
"This network is a backbone of health defense," says Frieden. "If it collapses, the U.S. and the rest of the world will be flying blind."
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