When a government inherits a functioning public health system, the least expected of it is not to break it. Bangladesh, unfortunately, is now living through the consequences of that expectation going unmet.
The numbers are stark. Measles vaccination coverage in Bangladesh fell to approximately 59 percent in 2025, a dramatic decline from what had previously been a program approaching the 95 percent threshold that epidemiologists consider the minimum necessary for herd protection against a disease as contagious as measles. That gap of nearly 36 percentage points does not represent a statistical abstraction. It represents hundreds of thousands of unvaccinated children, each one a potential case, each case a preventable tragedy.
To understand how Bangladesh arrived here, one must go back further than the current crisis. The last major national measles-rubella campaign was conducted in 2020. A follow-up campaign planned for 2024 was not implemented on schedule, leaving a significant cohort of children born in the intervening years without the supplemental protection that such campaigns are specifically designed to provide. Public health specialists refer to this accumulated deficit as an immunity gap and in the case of measles, immunity gaps have a way of announcing themselves loudly.
What compounded this structural lapse was a policy decision that, whatever its intentions, proved damaging in practice. The interim administration chose to move away from the established UNICEF and Gavi-supported procurement framework for vaccines, replacing it with an open tendering process. Procurement reform is not inherently wrong. Transparency in public spending is a legitimate goal. But the transition was handled without adequate preparation, and the consequence was delay in sourcing, delay in supply, and ultimately, shortages at the field level. Children who were due for second doses and booster shots did not receive them on time. Districts that should have had adequate stock reported running dry.
Allegations have also emerged not yet independently verified that data related to the outbreak was removed from official government platforms, and that the scale of child mortality in affected divisions including Dhaka, Rajshahi and Chittagong is considerably higher than what has been publicly acknowledged. These claims warrant serious, transparent investigation. A government that is confident in its record does not suppress data. And a public that has watched its children fall ill deserves more than silence.
The current administration has responded by launching a nationwide emergency vaccination drive running through the 10th of May. This is the right instinct, and the effort should be seen through completely. But a remedial campaign, however well executed, cannot undo what has already occurred. The children who contracted measles during the window of institutional failure did not have the luxury of waiting for policy to course-correct.
What Bangladesh needs now, beyond the immediate campaign, is a full and honest accounting. How did a procurement reform proceed without contingency planning for supply continuity? Why was the 2024 campaign not implemented when the immunity gap was already known to health officials? Who was informed of field-level shortages, and what decisions were taken in response? These are not partisan questions. They are the questions any serious society asks when preventable disease claims young lives.
Vaccination program is among the most cost-effective investments a state can make. They are also among the most fragile dependent on continuity, logistics, public trust and institutional competence in equal measure. Bangladesh spent decades building the infrastructure and coverage rates that made its immunization program a model in the region. That progress was not inevitable, and it is not irreversible. The current crisis is proof of both.
Accountability here is not about assigning political blame. It is about establishing what happened clearly enough that it cannot happen again. The children who bore the cost of this failure were not old enough to have any opinion about the decisions that endangered them. That alone should weigh heavily on those who made those decisions, and on those who are now charged with ensuring the answers come to light.