The current measles outbreak in Bangladesh raises a fundamental question: How did a preventable disease manage to make a comeback? The first measles cases were reported in Rohingya camps near the Myanmar border in January. By early May, thousands of people had been infected, and more than 200, mostly children, had died of measles or measles-like symptoms. Hospitals in Dhaka are running out of space, and patients are being treated on the floor due to a shortage of beds. It has been found that a large proportion of those infected have not received a single dose of measles-rubella (MR) vaccine.
Measles is a highly preventable disease if the vaccination programme works properly. Bangladesh has maintained such an effective system for the past two decades. Regular vaccination, supplementary campaigns, and cooperation with international partners ensured an uninterrupted supply of vaccines. Although this process was very effective. By following this process, more than 95 percent of children were able to be vaccinated, and the virus was prevented.
This success was no coincidence. Bangladesh maintained this target by providing two MR doses at 9 and 15 months of age and conducting national catch-up campaigns every four years. This system is procured by UNICEF and funded by Gavi, and the government was internationally recognised and reliable.
In September 2025, the interim government led by Professor Muhammad Yunus decided to suspend the purchase of vaccines through UNICEF and introduce an open tendering system in order to increase transparency. The then UNICEF Country Representative, Rana Flowers, strongly opposed this decision and warned Health Adviser Nurjahan Begum that it could disrupt the vaccination programme and increase the risk of an outbreak. Rana Flowers later said that she had informed the Health Adviser of this risk on an urgent basis. However, the Health Adviser did not respond to any media questions on the matter.
Then began the bureaucratic complexities that culminated in this devastating health crisis. The finance ministry expressed concerns about the new procurement model, and the auditor general raised the issue of unresolved accounts from the previous year. The government eventually reverted to purchasing vaccines through UNICEF, but it was too late. Vaccine stocks ran out, and the suspended supplementary MR campaign was cancelled altogether. The government report from March 2026 showed that only 59 percent of children were vaccinated in 2025. Although that information was later removed from the website.
One thing is clear from the whole incident: an effective supply system collapsed due to policy decisions. Despite repeated warnings from relevant agencies, they were ignored. This resulted in the spread of the outbreak and the deaths of children. Whether there was any malicious intent behind the loss may only be known after an impartial investigation. The deaths were later described as a ‘human tragedy’ and condolence messages were offered. But public health responsibility is not judged by the language of sympathy alone, but by foresight. That is what was known when, and what action was taken accordingly. The requirement for 95 percent vaccination is not an obscure technical fact; it is a prerequisite for measles control. The consequences of changing the procurement process in the middle were clearly communicated in advance. This was not a failure that had to wait until the end of the incident to be understood. It was visible in real time.
On April 28, the human rights organisation Ain and Salish Kendra demanded that those responsible for ‘negligence or indecision’ in vaccination be held accountable. Their question is very logical. Accountability does not end with just expressing sympathy. There needs to be a formal investigation against those who have ignored international warnings and dismantled a functioning vaccination system. The names of those responsible must be made public. They must explain why they considered their decision to be correct, ignoring experienced organisations, so that this information can be used as evidence if any criminal investigation is needed in the future.
Bangladesh is not the first country to face such a crisis. A Brazilian Senate investigation identified officials who failed to control the pandemic. In the Philippines, a former health secretary has also been sued over vaccination-related incidents. While convictions are rare, conducting public investigations and publishing state-run reports is not new.
Bangladesh has the capacity to conduct such an investigation. A commission consisting of former judges and public health experts can be formed whose report will be made public and will be based on the information obtained in the investigation. Public representatives will decide on the next steps through discussions in parliament, which will serve as a benchmark to prevent the government from making wrong decisions in the future. Otherwise, policymakers will think that it is easy to avoid responsibility for the loss of lives caused by wrong decisions. If such thinking is established in society, our public health will be repeatedly put at risk.
The steps taken by the current government since April are commendable. Vaccine procurement has started through UNICEF, and Tk604 crore has been allocated on an emergency basis. The vaccination programme that started on April 5 to control the outbreak has vaccinated 11 million children as of May 1. However, this control system is not a substitute for accountability. The children who died did not die because measles is incurable, but rather because an effective system was destroyed despite warnings; their families deserve not only sympathy but a transparent explanation.
If the root causes of these wrong decisions and the identities of those responsible are not exposed, the same mistakes will continue to be repeated. Public health systems do not simply fail due to a lack of resources; they collapse when certain risks are ignored.
What is needed now is not just a response to the situation, but a full and transparent investigation into what was known, what decisions were made, what the reasoning behind them was, and who made them. Without a full investigation, this outbreak will remain an isolated incident. But if properly investigated, this incident could be the beginning of a significant turning point for future policy reforms.
The writer is a Faculty member, Central University of Science and Technology, Dhaka. Email: [email protected]
