How Canada became the centre of a measles outbreak in North America – BBC

Report on the 2025 Canadian Measles Outbreak: A Challenge to Sustainable Development Goals

Executive Summary

In 2025, Canada is experiencing a significant public health crisis with a measles outbreak exceeding 3,800 confirmed cases, predominantly affecting children and infants. This figure places Canada eighth globally for measles outbreaks and represents a rate nearly three times higher than that of the United States, despite a smaller population. The outbreak constitutes a severe setback for Canada’s progress towards Sustainable Development Goal 3 (SDG 3): Good Health and Well-being. This report analyzes the primary drivers of the outbreak, including declining vaccination rates and socio-cultural factors, and frames the crisis within the context of the UN’s Sustainable Development Goals, particularly SDG 3, SDG 10 (Reduced Inequalities), and SDG 16 (Peace, Justice, and Strong Institutions).

Analysis of the Outbreak in Relation to SDG Targets

Setback for SDG Target 3.3: End Epidemics of Communicable Diseases

The resurgence of measles, a vaccine-preventable illness declared eliminated in Canada in 1998, directly contravenes the objective of ending epidemics. The scale of the 2025 outbreak highlights a critical failure in maintaining herd immunity and protecting public health.

• Case Numbers: Over 3,800 infections have been recorded in 2025, the highest number since 1998.
• Provincial Epicenters: The provinces of Alberta and Ontario have been most severely affected, with Alberta reporting the highest per capita spread in North America.
• Vulnerable Populations: Infants too young for the standard 12-month vaccination schedule, such as the four-month-old case cited in Alberta, are disproportionately at risk, underscoring the community’s collective responsibility in disease prevention.

Challenges to SDG Target 3.8: Universal Access to Vaccines

The core driver of the outbreak is insufficient vaccination coverage, revealing significant challenges in ensuring universal access to and acceptance of essential vaccines. The MMR (measles, mumps, and rubella) vaccine, which is 97% effective, is the primary tool for prevention, yet its uptake has declined.

1. Rising Vaccine Hesitancy: A notable increase in vaccine hesitancy has been observed since the COVID-19 pandemic. Opposition that initially focused on COVID-19 vaccines has expanded to include routine immunizations.
2. Misinformation: The proliferation of anti-vaccine misinformation, suggesting immunizations are “dangerous,” has eroded public trust in established medical science.
3. Pandemic-Related Disruptions: Delays in routine childhood immunizations during the pandemic created a cohort of unprotected children.
4. Data on Declining Rates: In southern Alberta, the number of MMR vaccines administered dropped by nearly half between 2019 and 2024, providing quantitative evidence of the challenge.

Socio-Cultural Factors and SDG 10 (Reduced Inequalities)

Disproportionate Impact on Specific Communities

The outbreak’s trajectory reveals inequalities in health outcomes, a key concern of SDG 10. The initial spread in Ontario was concentrated in Low German-speaking Mennonite communities, where historical and cultural factors have contributed to lower vaccination rates.

• Community-Specific Spread: Health authorities traced the Ontario outbreak to a gathering, after which it spread rapidly among unvaccinated individuals within these communities.
• Complex Motivations: While some resistance is tied to cultural or religious beliefs, healthcare workers report that post-pandemic misinformation has become a significant new factor influencing decisions.

Systemic Barriers and Institutional Distrust

Achieving health equity requires addressing systemic barriers. Reports from healthcare workers serving these communities indicate that experiences of discrimination and a feeling of being “looked down upon” by the broader healthcare system have fostered deep-seated distrust. This alienation impedes effective public health outreach and undermines the goal of ensuring equal opportunity and access to healthcare for all, as mandated by SDG 10.3.

Public Health Response and Alignment with SDG 16 (Strong Institutions)

Effectiveness of Institutional Response

The crisis tests the effectiveness and accountability of public health institutions, a cornerstone of SDG 16. While authorities have taken steps, such as lowering the vaccination age in Alberta and issuing public bulletins, the response has been described as more “muted” than during the COVID-19 pandemic. A robust institutional framework is necessary to manage public health threats decisively.

The Critical Role of Accurate Information

The spread of misinformation directly challenges SDG Target 16.10, which calls for ensuring public access to information. The failure to effectively counter false narratives about vaccine safety has had severe consequences. Restoring public trust requires strong, transparent institutions that actively promote accurate, science-based information and protect citizens from harmful disinformation.

Conclusion and Recommendations for SDG Alignment

The 2025 measles outbreak in Canada is a multi-faceted crisis rooted in declining vaccination coverage, fueled by misinformation, and exacerbated by social inequalities. A return to progress on the Sustainable Development Goals requires a comprehensive and coordinated response.

• Reinforce SDG 3: Launch robust, high-visibility public health campaigns to re-establish the importance of routine immunizations and communicate the severe risks of measles, thereby protecting community health and well-being.
• Advance SDG 10: Develop and fund culturally competent and trusted healthcare outreach programs, such as mobile clinics, to engage directly with underserved communities, address historical distrust, and ensure equitable access to vaccines.
• Strengthen SDG 16: Fortify public health institutions by investing in clear, transparent communication strategies to actively combat misinformation and rebuild public trust in scientific and medical authorities.

Analysis of Sustainable Development Goals (SDGs) in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  This is the most central SDG in the article. The entire text focuses on a public health crisis: a major measles outbreak in Canada. It discusses the disease’s dangers (“pneumonia, brain swelling and death”), its impact on vulnerable populations like infants (“My four-month-old shouldn’t have gotten measles in 2025”), the importance of vaccines (“The MMR vaccine is the most effective way to fight off measles”), and the challenges of low vaccination rates and vaccine hesitancy.

• SDG 10: Reduced Inequalities

  The article touches upon health inequalities. It highlights that the outbreak disproportionately affects specific groups, such as “Low German-speaking Mennonite communities,” where vaccination rates are historically lower. It also points to a “general distrust in the healthcare system, which she said has historically ostracised members of her community,” suggesting unequal access or treatment. Furthermore, it emphasizes the vulnerability of infants who are too young to be vaccinated, highlighting inequality based on age.

• SDG 16: Peace, Justice and Strong Institutions

  The effectiveness of public institutions is questioned. The article explicitly states, “The data raises questions on why the virus is spreading more rapidly in Canada than in the US, and whether Canadian health authorities are doing enough to contain it.” This points to a need for effective and accountable health institutions to manage public health crises, build trust, and implement successful vaccination campaigns.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. Target 3.2: End preventable deaths of newborns and children under 5 years of age.

   The article’s focus on measles infecting “children and infants” directly relates to this target. Measles is a vaccine-preventable disease that can be fatal for young children. The story of Kimie, a four-month-old who contracted the virus, underscores the risk to this age group and the importance of preventing such illnesses to reduce child mortality.

2. Target 3.3: End the epidemics of communicable diseases.

   This target is directly addressed as the article describes a measles “outbreak” that has reached epidemic proportions in Canada, making it “the only western country listed among the top 10 with measles outbreaks.” The entire narrative is about the failure to contain a communicable disease and the efforts needed to stop its spread.

3. Target 3.8: Achieve universal health coverage, including access to safe, effective, quality and affordable essential medicines and vaccines for all.

   The core issue identified is the lack of universal vaccine coverage. The article discusses low vaccination rates, the rise of vaccine hesitancy, and disruptions in “routine immunisations.” Efforts to combat this, such as mobile clinics serving the Mennonite population and public health campaigns, are attempts to improve access to and uptake of essential vaccines, which is a cornerstone of this target.

4. Target 10.2: Empower and promote the social inclusion of all, irrespective of age, religion or other status.

   The article points to the exclusion or marginalization of certain groups from the healthcare system. The mention that the outbreak is concentrated in Mennonite communities, which have experienced historical ostracization and discrimination, connects to this target. Ensuring these communities trust and have access to public health services like vaccination is a matter of social inclusion.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Number of new infections of a communicable disease

  The article provides precise data that serves as a direct indicator for Target 3.3. It states there are “more than 3,800 in Canada who have been infected with measles in 2025,” with a peak of “more than 200 a week across Ontario.” Tracking this number is a primary way to measure the scale of the epidemic.

• Vaccination Coverage Rate

  This is a key indicator for Target 3.8. The article implies its importance by stating, “The only thing that is going to stop an outbreak is getting those vaccination rates up.” It provides a specific negative indicator: “the number of MMR vaccines administered has dropped by nearly half from 2019 to 2024” in southern Alberta. It also notes that “Almost all those infected were unvaccinated.”

• Morbidity Rate among children/infants

  While not providing a mortality rate, the article gives a morbidity indicator for Target 3.2 by specifying that most of the 3,800 cases are “children and infants.” The case of Kimie, who fell ill with a fever and rash and is being “monitored for potential long-term effects,” is a qualitative indicator of the disease’s burden on children.

• Disparity in health outcomes/coverage by population group

  An indicator for Target 10.2 is implied through the description of where the outbreak is concentrated. The fact that the illness “primarily spread among Low German-speaking Mennonite communities” where vaccination rates are lower suggests a disparity in health coverage and outcomes that could be measured and tracked.

4. Table of SDGs, Targets, and Indicators

Source: bbc.com