Bangladesh was successful in controlling rubella in 2018 and was supposed to eliminate measles and rubella from the country this year, but now it is struggling to deal with a measles outbreak.

Hundreds of children are now in hospitals with measles and related complications, and the authorities are scrambling to contain the surge of the highly infectious disease.

Experts said although the country has exhibited remarkable immunisation efficacy over the past few decades, vaccination gaps have left many children at risk.

In the absence of systemic reform, emergency measures like those taken in the current situation to control the measles outbreak will not yield significant benefits, they said.

A total of 118 suspected measles deaths, mostly children, have been reported since March 15, including five in the last 24 hours ending at 8:00am yesterday, according to the Directorate General of Health Services.

At least 8,534 suspected cases were reported nationwide since March 15, including 1,282 suspected ones in the last 24 hours, the directorate said.

As of yesterday, 2006 suspected measles patients, mostly children, were undergoing treatment at hospitals across the country, it said.

“Bangladesh’s immunisation achievements were lauded worldwide and had significantly reduced deaths among children under five. From that situation, we are now witnessing a measles outbreak in the country...”

Prof Be-nazir Ahmed, former director of disease control at the DGHS

However, the DGHS has so far been able to test and confirm 20 measles deaths and 1,099 cases.

Samples from suspected measles patients are tested at reference laboratories in Dhaka, a process that takes a considerable amount of time. Meanwhile, suspected cases are included in the list, and confirmed cases are updated later, creating a discrepancy between the two figures.

Besides, rash and fever, the main symptoms of measles, are common to several other diseases, officials said. Therefore, not all suspected measles cases are ultimately confirmed, which contributes to the difference between suspected and confirmed deaths, they added.

The government on Sunday launched an emergency vaccination drive at 30 upazilas of 18 districts where the infection rates were relatively high.

On the first day, 76,123 children from six months to under five years were vaccinated, which is 95.8 percent of the first-day target, officials said.

Against this backdrop, the country is observing World Health Day with the theme “Together for Health. Stand with Science”. Different government and non-government organisations have planned programmes to mark the day.

UNMET TARGET

Prof Be-nazir Ahmed, a health expert and former director of disease control at the DGHS, said Bangladesh’s immunisation achievements were lauded worldwide and had significantly reduced deaths among children under five.

“From that situation, we are now witnessing a measles outbreak in the country, with hundreds of children fighting for their lives at hospitals,” he told The Daily Star yesterday.

He added that the sudden scrapping of the sectoral programme, under which funds for vaccination were provided, by the interim government triggered a measles vaccine crisis, leading to the deaths of many children.

“When we are supposed to celebrate something positive on World Health Day, we have to fight an outbreak, which is very unfortunate.

“We are supposed to eliminate measles-rubella by 2026, but we are struggling with the growing number of measles patients at hospitals.”

According to the latest Expanded Programme on Immunisation (EPI) Coverage Evaluation Survey in 2023, the country recorded a commendable 95.2 percent crude coverage, which means both valid and invalid vaccinations.

It recorded an impressive 81.6 percent full valid coverage (children receiving all doses of all vaccines up to nine months of age) among children under one year of age.

But data from the EPI shows crude vaccination coverage under its regular campaign declined over the past two years.

Particularly, measles-rubella vaccination rate saw a deep decline in the last two years. Children aged nine months were administered MR-1 vaccine, while children over 15 months were given MR-2 vaccine under the regular immunisation programme.

EPI data shows MR-1 and MR-2 coverage declined since 2023.

Special campaigns are held every four years to cover those missed in routine vaccination, with the last campaign held in December 2020 and January 2025.

But the special campaign planned for late 2024 could not be conducted due to the situation surrounding the political changeover.

The interim government did not carry out any such drive. Health assistants, who give the children the shots, went on strike three times in 2025, disrupting the regular vaccination programme, said health officials.

The EPI authority also had to ration vaccines in some areas since January due to a shortage caused by a fund crisis, an official told this correspondent on condition of anonymity.

Mushtaq Husain, another public health expert, said the government has undertaken an emergency vaccination drive to control the spike in measles cases and deaths.

However, instead of relying on emergency measures, the system needs reform to ensure sustainable progress in the health sector.

He added that the Health Sector Reform Commission in 2025 has made several recommendations, including the formation of a permanent health commission and a separate directorate for public health, but the current government is yet to start implementation of the suggestions.

“Unless we reform the system, we will have to resort to emergency measures whenever the situation deteriorates,” he opined.