STANLEY Gwavuya, acting representative of the United Nation’s Children Fund to Bangladesh, very recently spoke to a local Bangla newspaper on the current measles situation in Bangladesh. In the interview, he said that UNICEF had repeatedly warned the interim government about the possibility of a surge in measles-related cases and deaths if there was a measles vaccine stockout that might ensue if the government changed vaccine procurement processes. The interview, especially in its updated (redacted) version issued on 05 May 2026 which removed certain earlier elements, raises questions that are better understood against UNICEF’s vaccine procurement timeline for Bangladesh.
Gwavuya’s remarks that UNICEF ensures access for every child, regardless of location, to life-saving vaccines need some specificity. UNICEF procures vaccines with funds from the Vaccine Alliance-Gavi and the Government of Bangladesh, and charges 4 per cent as handling fee. These vaccines are delivered to the Expanded Program on Immunisation head office in Dhaka. After the cessation of the Sector-wide Approach in the health sector, the conveyor belt of which was the operational plans (OP), through which development budgets used to flow, including those for the vaccination programme, also ceased. In the absence of an alternate development project, which the Planning Commission and the Ministry of Health & Family Welfare (MoH&FW) failed miserably to develop and approve, the pipeline for development funds dried up. This was a grave mistake on the part of the interim government. It, however, was not as disastrous for vaccination as it was for all other types of services in the health sector. Be that as it may, procurement of vaccines, as a stop-gap measure, started from the operational (revenue) budget of the government, which is customarily released by the Ministry of Finance.
Until the end of 2024, vaccines procured earlier from the OP fund within June 2024 were adequate for the year. But the money for transferring vaccines from Dhaka to the vaccination spots waned by the end of 2024. UNICEF transports vaccines up to district level with funds from Gavi, but only for campaigning, and the World Health Organisation, also with funds from Gavi, ensures availability of vaccines up to the vaccination spots, again only for campaigning. With ingenuity, this conduit was also used for transporting vaccines for routine immunisation, as government funds were no longer available for the same purpose from the usual source. The operational costs that the UN organisations receive from Gavi used to be handed to the government earlier, but with the twist of time these now go to the UN organisations directly, the stated reason for which remains foggy. Since assuming responsibility for this operational fund, UNICEF has also procured the auto-destructive syringes used for vaccination from abroad, although these used to be purchased domestically.
At this point, let me inform interested readers that before the end of 2024, on 28 December 2024, UNICEF received Tk 458 crores directly from the GoB for procuring routine vaccines, which arrived in Bangladesh on 29 January 2025 and 30 September 2025. If a measles outbreak was so imminent, one may ask why two lots of vaccines arrived at a gap of eight long months. As per the decision of the Government and Gavi to hold the measles campaign in Bangladesh in September 2025, since it was overdue, the first lot of MR vaccines for campaigning arrived in Bangladesh on 8 September 2025. The question is: if UNICEF was so concerned, why was the campaign not held in September? Who was responsible for this shift, and why? We can say with certitude that had the campaign been conducted in September 2025, we might not have witnessed the pathetic scenes of measles deaths that we see today.
Gavi provided $18.5 million for vaccines, freight, and vaccine paraphernalia, and USD 7.9 million as operational cost, which included within-country transportation, the cost of microplanning, orientation, training, communication and communication materials. Thus, nothing remained to be financed from any other source for the campaign, except the government’s co-financing of Tk 12 crores. Let us note that the first of the three lots of UNICEF’s pre-financed vaccines arrived on 21 August 2025, while the third, that is, the final lot, arrived on 29 April 2026. Are these supply dates indicative of a badly brewing situation? Why did UNICEF not bring all its pre-financed vaccines within the span of 2025, instead of bringing them in three lots, with the last one arriving only on April 29, 2026, if the situation was indeed worsening?
For the sake of argument, let us agree that there could have been a possibility of a stockout of vaccines in Bangladesh from November 2024 to January 2025, but only at the vaccination spots, and not because of paucity of vaccines, rather because of the unavailability of OP funds from the MoH&FW, which used to cover transportation costs of vaccines to the vaccination spots. We may vouchsafe at this point that even if there had been a paucity of vaccines during those two or three months, the current measles outbreak should not have happened if vaccines procured between 29 January and 30 September 2025 for routine vaccination and campaigning, including those from UNICEF’s pre-financing, had been used. This is because the incubation period of measles — the time between entry of the pathogen into a host and appearance of clinical features of the disease — is at most 20 days. We know that the first cases of measles came to notice in January 2026 from the Rohingya camps of Cox’s Bazar. Therefore, measles infection definitely did not begin there before November 2025. Repeatedly blaming the current outbreak on vaccine stockouts due to changes in the procurement process does not therefore appear plausible. If the situation that UNICEF claimed to have repeatedly informed the government about before mid-February 2026 was true, then even campaign-related vaccines received in September 2025 and January 2026 should have been used if there had been a shortfall in routine vaccine stock, which, however, does not appear to have been the case from the account given above.
The other reason cited for the outbreak was delayed surveillance reporting. But as stated above, the first cases of measles were reported in January 2026 among the Forcefully Displaced Myanmar Nationals camped in Cox’s Bazar. We know that most of the major health-related organisations in Bangladesh have their presence in Cox’s Bazar, but startlingly enough, no organisation or expert committee appears to have taken those sporadic cases into cognizance. Therefore, blaming other partners for missing these measles cases does not appear to be an act of camaraderie. Does it? In any case, had that clue been deciphered in time, a vaccine campaign could and should have been the natural decision, unless, however, there were other priorities.
On May 20, 2026, in a press conference, the Country Representative of UNICEF revealed that UNICEF pre-financed vaccines worth $17.8 million in 2025, which fetched one-third of the total requirement. As mentioned above, the GoB’s Tk 458 crores was sufficient for procuring the remaining two-thirds of the vaccines for 2025, going by UNICEF’s own estimate. In addition, UNICEF supplied the first lot of Gavi-financed measles vaccines for campaigning in September 2025, which was part of the $17.13 million of the total $18.5 million package. The second lot, according to Stanley Gwavuya, arrived in January 2026. These facts show that there could have been no shortage of vaccines even in 2026, as clarified further below.
The Cabinet Committee of the Bangladesh Government for Procurement approved Tk 421 crores of public funds for UNICEF in November 2025, of which Tk 419 crores was spent, along with APVAX funds amounting to Tk 609 crores, which was the balance from the loan obtained by the government from the Asian Development Bank in 2023 for Covid-19-related services. Because of the cessation of the OP in the health sector, responsibility for managing sectoral procurement funds was bestowed on the core officers of the Directorate General of Health Services, who had to face the audit department for expenditures that UNICEF would incur. Moreover, release of the funds became a lengthy and tortuous process. UNICEF received the funds on 13 April 2026. From these funds, UNICEF took its cut of the pre-financed $17.8 million and the government’s co-financing contribution of Tk 12 crores, which the government customarily pays whenever there is a campaign. UNICEF supplied vaccines for routine vaccination on April 29, and May 6, 2026, along with its pre-financed vaccines worth Tk 200 crores, from these Tk 1,028 crores. If vaccines worth Tk 200 crores constitute one-third of a year’s requirement, according to the Chief of UNICEF in Bangladesh, then readers may calculate for themselves how long vaccines procured with Tk 1,028 crores should last.
Let us ask ourselves a question, why were all these vaccines not used for campaigning if the situation was so dire in January, February, or March? As mentioned earlier, the measles campaign was ab initio planned for September 2025, which was later shifted to January, when the second lot for campaigning arrived and then shifted again to June 2026. This aptly proves that the measles outbreak was not anybody’s concern until late March 2026 and until the current government took the reins. Why did the concerned bodies and UN organisations not hurriedly advise the government to institute a measles campaign in January or February, instead of shifting it again to June 2026 and remaining confined to issuing warnings related more to the vaccine procurement process?
One letter that UNICEF mentioned, dated February 10, 2026 and sent to the interim government, came at a time when the interim government was already in a departing mode. This letter also heavily emphasized the previous issue, with no direct mention of a measles uptick. Since UNICEF was ‘formally’ informed about the measles outbreak only in late March 2026, it naturally follows that it could not have directly cautioned the interim government about it.
Now let us examine why the measles campaign was deferred. The campaign for measles vaccination was deferred in favour of prioritising typhoid and human papillomavirus campaigns. It is interesting that neither Stanley Gwavuya in his interview nor Rana Flowers, the UNICEF country representative, in the press conference, spoke about the postponement of the campaign — not once, but thrice — over a span of nine months. Why was a serious event that had been brewing forgotten or sidelined, while TCV and HPV campaigns were prioritised instead, even as measles vaccines meant for campaigning gathered dust in the EPI store? Therefore, one may conclude that the current outbreak resulted from overlooking the real threat of a measles outbreak and showing greater interest in conducting TCV and HPV campaigns in lieu of a measles campaign. It is therefore imperative that the responsibilities and decisions of the partners, expert committees, officials, and ministries during the interim period be investigated thoroughly and honestly. The investigation must particularly examine whether UNICEF’s interest lay more in preventing changes to the procurement process, since such changes would affect its 4 per cent handling fee and operational budgets amounting to millions. Besides this, we also need to explore what benefits accrued to those who favoured TCV and HPV campaigns. In this regard, the role of the Interagency Coordination Committee of the MoH&FW also needs examination.
UNICEF should be credited for mobilising additional technical expertise and emergency funding through its global emergency response mechanisms. The people of the country would appreciate it if these were done in consultation with and under the monitoring of the government. According to Stanley Gwavuya, UNICEF also worked closely with partners and donors such as the US and others to secure additional resources to support the national measles response and similar emergencies. The people of this country would like to know how much additional resources were garnered, where these came from, and where, when, and for what purposes these were used. Wisdom would warrant that the formal agreement between the Government and UNICEF for ‘ensuring timely, cost-effective, and equitable access to quality-assured vaccines’ be tested periodically. In light of Stanley Gwavuya’s claims regarding the enormous number of creditable things UNICEF does, the organisation also has to clarify unambiguously whether it merely assists the government of Bangladesh or independently leads system-related functions, including community interventions, planning and implementation, besides financing immunisation-related actions, as many of these issues were overshadowed by his multifarious claims.
Dr Abu Muhammad Zakir Hussain holds a PhD in biomedical sciences (epidemiology and biostatistics) from the University of Hawaii, USA. He is a former director of primary health care and disease control at the Directorate General of Health Services. He also previously worked as a Regional Adviser on Environmental Health and Climate Change at the World Health Organisation’s South-East Asia Regional Office. The writer acknowledges Dr Tajul Islam Bari, consultant and former EPI colleagues for their inputs.
