Kennedy's Best Defence Is a List of Countries That Failed
Mexico, Canada, England - every nation the health secretary named as proof America is winning has been delisted or downgraded
Asked on CNN’s State of the Union whether he accepts responsibility for US measles cases reaching a 35-year high, Health Secretary Robert F. Kennedy Jr. reached for the world map. Mexico, he told Dana Bash, has fifteen times the per-capita rate. Canada four times. England two. This is an international outbreak, he argued, and America is handling it better than anyone.
The numbers are broadly right. The defence is not. Canada lost its measles elimination status in November 2025 after more than a year of endemic transmission and 5,425 confirmed cases (The Public Health Agency of Canada was contacted for comment and said it would respond later this week). The United Kingdom followed in January. Mexico, like the United States, remains under review. Kennedy benchmarked America against countries that have already failed the test it is currently sitting.
And America has already lost part of what he was defending. When PAHO stripped Canada, the entire Region of the Americas forfeited its certification as free from endemic measles - under the regional framework, transmission in one member state ends it for all. The Americas is the only WHO region ever to have eliminated measles, a distinction it has now surrendered twice. Kennedy’s benchmark country is the reason the hemisphere, the United States included, no longer holds it.
Armenia shows why national statistics mislead. In January, WHO's European verification commission delisted Armenia, Austria, Azerbaijan, Spain, the UK and Uzbekistan for sustained transmission. Yet Armenia was simultaneously one of only ten countries in Europe that WHO and UNICEF estimated had reached 95 percent coverage for both MMR doses. Strong national averages conceal weak communities. When we ran polio vaccination campaigns in northern Nigeria with UNICEF, one stubborn village head was enough to create a hotspot.
Washington’s own agencies behave accordingly. The CDC’s Level 1 global measles travel health notice remains in force, and its country list includes Armenia, the UK, Austria, Azerbaijan, Uzbekistan, Romania, Türkiye, Russia, Kazakhstan, Georgia and Belarus. One arm of the US government treats measles as an active international threat. Its health secretary treats it as a talking point.
Kennedy’s second argument is that today’s outbreaks trace to children who missed shots during COVID. There is truth in it, but the CDC’s own data show something wider: half of this year’s cases are among five-to-nineteen-year-olds, a fifth in children under five - many born after restrictions ended - and nearly a third in adults over twenty. That is not the aftershock of one disrupted cohort. It is cumulative erosion, and it is measurable. Kindergarten MMR coverage has fallen from 95.2 percent in 2019-20 to 92.5 percent in 2024-25, below the threshold required to stop one of the most contagious viruses known.
Honesty requires conceding the other half. Much of today’s skepticism was manufactured not by activists but by governments - the heavy-handedness of COVID-era mandates, the jurisdictions where refusing a shot cost people work or travel. That coercion left a residue of resentment now attaching itself to vaccines with nothing to do with COVID. Rebuilding coverage means reckoning with that, not dismissing it. That’s my take.
Years ago PAHO commissioned me to work on a book marking the Americas' elimination of measles, which put me across the table from many of the world's leading MMR researchers. It was never published. Eliminated 2016. Lost 2018. Regained 2024. Lost again a year later. Elimination is not a trophy. It is a receipt.
Covering immunization in Ukraine taught me the rest: the enemy of vaccination is rarely the needle. It is the rumour. Bad information outruns any outreach campaign, parents grow frightened, coverage slips a few points - and the slippage stays invisible until an outbreak reveals it. Ukraine learned this. Canada learned it. America is learning it now, from a health secretary who spent years amplifying the doubt his department must now overcome.
Nor is measles a routine childhood illness. Between one and three infected children per thousand die, according to the CDC. About one in a thousand develops encephalitis, which can cause permanent neurological damage. One in five unvaccinated Americans who catch it is hospitalized. The virus also induces immune amnesia, degrading protection previously acquired against other diseases. Surviving measles is not the same as escaping it.
The global picture is worse. Fifty-seven countries recorded outbreaks in 2025. First-dose coverage is stalled near 84 percent against the 95 percent needed, leaving 13.5 million children with no dose at all. More than half of them live in fragile or conflict-affected states, where insecurity and displacement break the routine schedule before misinformation ever gets a chance to. I write this from a city, Odesa, under regular air attack, in a country that has spent four years trying to keep clinics running through it. Sudan, of all places, posted one of last year's largest coverage gains - even war is not destiny, provided someone funds the access. WHO warns that cuts to global health funding will widen these gaps. Kennedy is right that measles ignores borders. That is an argument for surveillance and vaccination, not against them.
Reporting on that book I mentioned earlier took me to a Bogotá mega-slum, following a vaccination campaign through neighbourhoods where a printed leaflet was useless. What worked was a billboard you could read at a glance and a man in a Spider-Man suit, posing with a child who had just taken the needle. What made the hemispheric achievement possible, I was told repeatedly, was unity - first ladies across the Americas, Hillary Clinton among them, publicly urging parents to vaccinate. Elimination was won by governments that agreed with each other and by campaigns built for people who couldn't read the pamphlet. Neither condition holds now.
PAHO's verification commission meets again in November to decide whether the United States keeps a status it currently records as "sustained with major concerns." Until last year, the commission had consistently designated the US as having sustained elimination outright. The second half of that new phrase is getting harder to ignore.
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