immunization levels for polio and measles as examples were 99 %, compared to 79 % for ESAR and, 81 % and 78 % respectively for Africa as a whole. Eritrea‟s complete country document for polio free status is also recognized by The Africa Regional Certification Commission (ARCC). 147. Similarly, Eritrea is the first country in East Africa to eliminate maternal and neonatal tetanus. Although sporadic measles outbreaks have been experienced, particularly in unimmunized adults, measles-related child deaths have been reduced to below standard. Hence, it is not considered as a public health concern for children below 5years of age especially after the introduction of second dose of measles in 2013 .This is intrinsically related to the efforts made to uphold the right and safety of children and mothers nationwide. 149. As revealed in this table, the trends in Maternal Mortality: 1990 to 2015 Estimates by WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division (WHO, 2015), reveal that the Maternal Mortality Ratio has declined from 1,590 per 100,000 live births in 1990 to 501 in 2015, and projected to 485 per 100,000 live births in 2016. Accordingly, MMR decreased by 70 percent from 1990 to 2016. The annual rate of reduction for Maternal Mortality Ratio during 1990-2016 was estimated at 4.6 %. Eritrea‟s health policy also addresses Maternal Mortality Ratio Estimates per 100,000 live the safety and protection from major births, 1990-2015 health threats and diseases. This mainly targets malaria, TB, HIV/AIDS and other communicable diseases. Malaria is endemic in Eritrea and considering it as a major public health concern, the Government launched a Roll Back Malaria Strategy in July 1999. Since 1999 the overall malaria morbidity has gone down by 90 percent, while the overall mortality due to malaria has decreased by 86 percent. In this regard, Eritrea‟s exemplary achievement has got recognition by the AU and on January 30, 2016, Eritrea received the Alma Award for Excellence in the Malaria Fight. The TB incidence of about 90 per 100,000 is also the lowest rate in the Horn and Eastern Africa Region. Comparison of 1990 (year before Indicators 1990 2014 Reduction Eritrea became independent) and 2014 243 78 68% Incidence of TB is given in the above table. 150. 151. Eritrea has also taken measures to halt the spread of HIV. HIV prevalence has been reversed while still at a low level, with a current estimate of 0.9 % Prevalence of TB Mortality due to TB TB/HIV mortality TB/HIV incidence 478 12 123 4.7 2 4.9 74.3% 60.8% Control of Tuberculosis – estimated per 100,000 people Page 32 of 100