Vaccine hesitancy in wealthy countries has made global measles eradication unrealistic for now, Microsoft co-founder and philanthropist Bill Gates told Reuters.
Gates said his foundation once considered measles eradication a possible long-term goal. However, growing doubts about vaccines in richer nations have changed that outlook.
“At one point, the foundation wanted to eradicate measles,” Gates said. He added that vaccine hesitancy in wealthy countries meant the goal was no longer on its list.
Vaccine Hesitancy Creates New Measles Risks
Measles remains one of the world’s most contagious diseases. It can cause high fever, coughing and a distinctive rash.
Although vaccination has dramatically reduced deaths, the disease continues to kill children, particularly in communities with weak healthcare systems and limited access to vaccines.
The World Health Organization estimates that about 95,000 people died from measles in 2024. Most were children under five who had not received enough protection.
Moreover, vaccination gaps have allowed measles to return in some wealthier countries where the disease had once been largely controlled.
Measles Needs High Vaccination Coverage
Health experts say communities need very high vaccination coverage to prevent measles from spreading.
WHO recommends maintaining at least 95% coverage with two doses of measles vaccine in every community. When coverage falls below that level, outbreaks can quickly develop.
Global coverage remains below that target.
WHO says 84% of children received their first measles vaccine dose in 2025, while only 77% received both recommended doses. Around 29 million infants remained under-protected against measles that year.
Therefore, even small declines in vaccination rates can create serious risks.
Measles Cases Return in Wealthier Countries
Recent outbreaks have shown that wealthy nations are not immune to measles.
The United States has experienced a major resurgence, while Europe has also reported outbreaks. Reuters reported that US trust in measles vaccines has fallen, with only 76% of Americans saying they believe the vaccines are safe in a recent Reuters/Ipsos poll.
At the same time, WHO and UNICEF have warned that measles remains a threat across Europe and Central Asia.
Although cases fell in 2025, health officials said vaccination gaps could allow the virus to spread again.
Gates Warns Against Global Spread of Vaccine Doubts
Gates said he remains concerned that growing vaccine skepticism in wealthy countries could influence attitudes elsewhere.
However, he said the Gates Foundation has not seen a similar increase in vaccine hesitancy in the lower-income countries where it works.
That distinction matters because measles can become especially dangerous in communities affected by malnutrition, limited healthcare and weak immunization systems.
Gates warned that vaccine doubts could become a global problem if they spread beyond the countries currently experiencing them.
Rich Countries Are Not the Only Challenge
While vaccine hesitancy has received significant attention, access remains another major obstacle to measles control.
Many children still live in places where conflict, poverty and fragile health systems make routine vaccination difficult.
WHO says more than 95% of measles deaths occur in low-income countries with weak health infrastructure.
Consequently, global measles control requires both strong vaccine confidence and reliable access to immunization.
Aid Cuts Add Pressure on Global Health
Gates also discussed the impact of cuts to international development assistance.
He said reductions in aid from the United States and other wealthy countries had likely contributed to deaths in poorer nations.
However, some funding has returned, while affected countries and health organizations have taken steps to prevent the worst outcomes.
Gates said the most severe predictions of more than 10 million additional deaths now appear unlikely. Still, he described the situation as deeply concerning and urged governments not to cut aid further.
Measles Eradication Remains a Difficult Goal
The latest warning highlights how difficult it is to eliminate a disease that spreads so easily.
Vaccination has already prevented millions of measles deaths. WHO estimates that measles vaccination prevented nearly 59 million deaths between 2000 and 2024.
Yet progress can quickly reverse when vaccination rates decline.
For now, Gates believes global eradication is no longer a realistic goal for his foundation. Still, improving vaccination coverage remains one of the most effective ways to protect children and prevent dangerous outbreaks.
Ultimately, reducing vaccine hesitancy and closing immunization gaps will remain essential if countries want to push measles closer to elimination.
