AN OUTBREAK of measles, a highly contagious viral infection, across the country is an indication of a weakening immunisation programme. At least 35 children have died from measles and several hundred others have been infected across the country since January. On March 28, about 30 patients were undergoing treatment in Bangladesh Shishu Hospital, with one new reported death. At Infectious Disease Hospital in Dhaka, as many as 222 measles patients were admitted in a single day in the middle of March. On March 26, four infants were admitted to Rangpur Medical College Hospital, with measles. Two of them died the next morning while awaiting care in the intensive care unit. The health minister said the government had expanded treatment facilities and initiated vaccination drives to control the situation. Officials of the Expanded Programme on Immunisation have also confirmed that resources were available but noted that key logistical and policy decisions were still pending. In the midst of an outbreak, when such decisions should be treated as the highest policy priority, it is concerning that they remain unresolved.
Even more alarming is the indication that the surge in measles infection is closely linked to the halt in vaccination campaigns after the suspension of operational plans in the health sector. In February 2024, an acute supply shortage of life-saving vaccines listed with the immunisation programme was reported amid allegations of a delayed release of funds. At the time, parents in districts such as Rangpur, Dinajpur, Bhola, Jashore and Barishal alleged that their children were denied vaccines in vaccination centres. The government collects the vaccines through UNICEF in co-financing with Gavi, the Vaccine Alliance. A delay in the release of the fund created the shortage and disrupted the service. This delay is partly caused by the policy shift from the long-standing operational system to an umbrella approach under the health sector reform initiatives. Officials have admitted that the transition was not accompanied by an alternative implementation strategy, causing delays in procurement and field-level coordination. The situation at hand reveals the fragility of the health system and the indifference of the policy-makers that they could leave such a life-saving decision unattended.
The government must, under the circumstances, take urgent steps to address the policy vacuum created by changes in the implementation strategy of the national immunisation programme. In doing so, it should establish an early warning mechanism for supply shortage to prevent outbreak situations. It should also review its procurement policies for life-saving supplies. Given that the shortage was reported a year ago, the government must investigate whether any official negligence delayed raising concerns about a potential disruption to the immunisation programme.
