Since 1998, with support from international donor agencies, the country introduced the five-year Health, Population, and Nutrition Sector Program (HNPSP). Before that, immunisation and other public health activities were carried out through more than a hundred separate projects, which were later brought under HNPSP. The fourth phase of HNPSP ended in June 2024.
According to a report published on 20 February 2025, by the daily Ajker Patrika, the fifth phase of HNPSP, worth 1,06,100 crore taka, was supposed to begin in July of that year. However, it was not approved at the time by the then Awami League government, although preparations for documentation had reportedly begun.
In this regard, public health expert and former EPI program manager Dr. Tajul Islam, in a conversation with The Daily Star, stated that although preparations for the fifth phase of HNPSP had started, the interim government canceled it and instead adopted a two-year DPP (Development Project Proposal) program. Under this, 1,451 crore taka was allocated for the first year. However, the funds were not released on time, creating a crisis in vaccine procurement. The last allocation for vaccines was released on December 28, 2024, and none has been released since then.
In such a situation, since June 2024, the salaries of thousands of workers under this program have been suspended. Even the workers who transport vaccines from upazilas to vaccination centers have not been paid for the past nine months.
Discussions with experts reveal that during the tenure of the Sheikh Hasina government, various objections were raised by the Health Sector Reform Commission regarding the HNPSP program. Allegations included widespread corruption, lack of coordination, and waste of resources in the implementation of previous programs. It was also alleged that under the cover of a large budget, certain political syndicates established monopolistic control over procurement and tender processes.
There was also a lack of coordination between the development and revenue budgets. To address these issues, the interim government attempted to move away from dependence on foreign aid and instead initiate the program with its own funding and management. However, due to shortcomings in planning and preparation, among other reasons, these reform efforts failed, leading to the current crisis.
