Child mortality is increasing at an alarming rate in the country due to a measles outbreak. According to data from the Directorate General of Health Services (DGHS), information on approximately 42,000 suspected measles cases has been recorded since March 15. More than 4,000 of these cases have been confirmed through testing. During the same period, about 311 children, have died with confirmed measles, measles symptoms, or suspected cases. Such deaths from a vaccine-preventable disease are not merely tragic; they brutally expose the limitations of the state’s public health system.
The emerging picture of the country’s public health situation is not just worrying; it is downright alarming. It has clearly morphed into a national public health crisis. The World Health Organisation (WHO) has explicitly warned that Bangladesh is currently at a high risk of a major measles outbreak. This warning is highly severe, as the infection has already spread to 58 of the country’s 64 districts. The majority of the infected are children, particularly those under the age of five. A country that was once known as a global role model for eliminating measles and rubella is now facing a severe health hazard.
In 2000, the coverage for the first dose of the measles vaccine was 89 percent, which later exceeded 100 percent. So, why this disaster today? According to WHO assessments, a severe shortage of the MR (Measles-Rubella) vaccine in the 2024-25 fiscal year and the irregular implementation of nationwide Supplementary Immunisation Activities (SIA) over the past five to six years are among the primary reasons. A large portion of those infected had not received any vaccines. Many had taken the first dose but failed to complete the second. Furthermore, chronic malnutrition and Vitamin A deficiency have rendered the immune systems of these children fragile. Experts note that the infection rate is also rising among children under nine months of age, indicating that infants are not receiving adequate antibodies from their mothers. According to experts, due to these underlying factors, affected children cannot be cured even with high-powered antibiotics. The infection rate is comparatively higher in densely populated slums, border districts, and among impoverished communities, serving as a harsh reflection of our social inequality.
Another area of grave concern is the lack of coordination. Experts have recommended forming a multilateral technical committee, strengthening surveillance, conducting special vaccination drives in high-risk areas, implementing hospital infection control, and raising public awareness. However, the pace of implementation is visibly lacking. At a time when new children are getting infected every day, the gap between policymaking and practical action is unacceptable. Instead of shifting blame, there is an urgent need for quick decision-making, accountability, and effective implementation. The most tragic part is that while the epidemic ravages the field level, a sense of apathy and lack of coordination is evident at the policymaking tier. According to reports, NITAG (National Immunisation Technical Advisory Group), an expert committee of the country’s top scientists, recommended the formation of a multilateral committee to tackle the crisis. Yet, according to the Health Minister’s own statement, he was unaware of such a recommendation.
According to public health experts, the government must urgently take several steps. First, the measles situation must be declared a national emergency health priority, followed by coordinated initiatives. Second, at least 95 percent coverage for the two-dose vaccine must be ensured. Third, special vaccination campaigns must be launched, prioritising vulnerable populations in slums, border regions, remote areas, and Rohingya camps. Fourth, Vitamin A supply, hospital preparedness, disease detection, and reporting mechanisms must be strengthened. Fifth, an effective technical committee must be formed immediately, as per expert recommendations, to make evidence-based decisions.
The geographic spread of the infection is also a matter of concern. The patient rate is high in densely populated slum areas of the Dhaka division, including Demra, Jatrabari, Kamrangirchar, Korail, Mirpur, and the Tejgaon industrial area. Moreover, the long borders with India and Myanmar, the free movement of people, and border districts – especially Jashore and Chapainawabganj – have increased the risk of cross-border transmission. This is exactly why the WHO considers not only Bangladesh but the entire South-East Asian region to be at high risk.
Regardless of who bears the blame for the political instability or administrative inefficiencies of past years, why should children have to pay the price with their lives? The glory we achieved in eliminating measles must not be allowed to turn to dust today due to negligence in the immunisation program. The Ministry of Health and the Directorate must jump into coordinated action immediately. We must remember that a single child’s death is not just a statistic; it represents a shattered dream for a family and a failure of the state. Measles is a preventable disease, so there is no room to side-step the infections and deaths of so many children by labelling them as ‘unexpected.’ It is fundamentally a reflection of weak vaccination systems, poor surveillance, and a lack of health coordination. There is still time – but that time is depleting rapidly. Immediate, effective, coordinated, and scientific action to save children’s lives must be the state’s foremost duty. The true strength of a public health system is tested in times of crisis; that time has now arrived. There is no room for denial, delay, or blame-shifting. There is no alternative to taking swift, coordinated, and science-based actions right now to save our children.
The writer is a Fellow in Palliative Care, St. Christopher’s Hospice (UK), Institute of Palliative Medicine (Kerela)
