The measles outbreak in the country has taken a dangerous turn. On 6 April, Prothom Alo's front page reported, "18 per cent of all children in Barguna, shortfall in vaccination programme arrangements".
According to the Health Directorate's data on 6 April, over 8,500 children have been hospitalised nationwide with suspected measles. Measles has been confirmed in 1,099 cases, and 118 children have died due to the disease.
Yet, according to the World Health Organisation's statistics, the number of children affected by measles in Bangladesh has been negligible over the past decade and a half. What happened that suddenly so many children started getting infected with measles, leading to the tragic situation of child deaths?
Public health experts have observed that this severe outbreak of measles is the grim consequence of lapses in vaccination programmes over a period of time. Unnecessary and unexpected complications arose related to purchasing these vaccines during the interim government. Due to the lack of foresight and activity of those involved in policy-making at the time, the children's vaccination programme almost came to a halt. Due to not stocking vaccines at the right time, many children were deprived of the necessary vaccines at the appropriate age.
The issue started before this, however. During the Awami League's term, the last measles and rubella campaign took place in January 2021, targeting children under 10 years old. After that, this government was also not seen taking any such initiatives. Broadly speaking, the negligence of the past two governments is to blame for this severe measles outbreak.
However, as a public health nutritionist, when examining closely, aside from the mishandling and unavailability of measles and rubella vaccines, other factors in this situation should also be discussed. Doctors note that a large portion of the children currently hospitalised with measles symptoms are under 9 months old.
According to the vaccination schedule, no child is given a measles vaccine before 9 months. This raises the question of how the government can be held accountable if children under 9 months old are affected by measles.
In reality, raising this question doesn't absolve the previous government of responsibility. Children who receive vitamin ''A'' every six months from the age of six months have a lower risk of contracting measles. When a child has sufficient vitamin ‘A’ reserves, they are less vulnerable to measles. Their immunity against various other diseases increases. But if there is a deficiency of vitamin ''A'', a measles-infected child’s risk for pneumonia, diarrhea, and other diseases increases, leading to potentially fatal outcomes. There is also a risk of blindness. The World Health Organisation, therefore, recommends feeding children vitamin ''A'' every six months.
This situation is partially responsible for the measles outbreak this time. Unfortunately, since June 2024, our children have not been receiving their regular bi-annual vitamin ''A'' supplements. After June 2024, they received vitamin ''A'' in March 2025, meaning after 9 months instead of six.
Afterward, they have been deprived of this supplement for approximately 13 months. Compounding this, the functioning of community clinics has also become lax. Consequently, children are not receiving necessary healthcare. All these factors combined have resulted in such an acute outbreak of measles this time.
Another notable reason is observed. It appears in regions where the number of measles patients is high, those areas are also lagging in terms of nutrition. From Prothom Alo’s report, I see that out of 17 children who died from measles, 5 were from the Barisal division. According to a recent UNICEF Multiple Indicator Cluster Survey report, in terms of nutrition indicators, the level of malnutrition in the Barisal division is considerably higher than the national average. Malnutrition is also a major factor behind the severity of the measles outbreak.
Through extended vaccination programmes, Bangladesh was able to set a unique precedent internationally. In the past, all political governments have taken vaccination programmes very seriously. The general populace of Bangladesh has also enthusiastically participated in vaccination campaigns. During the interim government, this longstanding successful programme almost came to a halt. They did not heed the repeated urgings of private and development partners. The dire price of this is now being paid by our helpless children.
Such painful human catastrophes are borne from our lack of minimal foresight and initiative. To prevent a larger catastrophe, it is now highly essential to prioritise nutritionally deficient regions in the country in the vaccination campaign. However, the primary issue is ultimately the improvement of the country's overall nutrition situation. For this, an urgent wake-up call must be delivered to the government and related parties.
*Asfia Azim is a public health nutritionist
#The opinion expressed is the author's own.