The recent outbreak of measles in Bangladesh and the child deaths have shaken the nation's conscience. Even as Bangladesh had shown success in effectively controlling preventable diseases like measles through its immunisation programmes, the loss of several hundred children's lives in recent months is not just a health crisis but a stark reflection of state failure.
Since Maurice Hilleman developed the measles vaccine in the 1960s, global child mortality rates have dramatically decreased. The most effective way to combat highly contagious diseases like measles is to establish ''herd immunity'' by ensuring high vaccination rates within a specific population group. This means that once a certain percentage of the population is vaccinated, a protective barrier is created for society at large, preventing the spread of infection. However, if this protective barrier breaks, the situation can turn dire. That is the reality we face in Bangladesh today.
Disruptions in regular vaccinations for children, delays in vaccine supply, and policy shortsightedness have contributed to a man-made crisis, as discussed in the media over the past several weeks. Meanwhile, news of new child deaths reaches us almost daily, and the corridors of hospitals echo with the cries of grieving family members.
On one hand, children are dying, and on the other, the political sphere is engaged in a blame game. The current Ministry of Health has blamed the previous Awami League government and the interim government. Some members of the interim government have pointed out the suspension of vaccine campaigns during the COVID-19 pandemic.
However, an interview with UNICEF's acting Bangladesh representative, Stanley Gwavuya, published in Prothom Alo on 5 May, has raised new questions. According to him, UNICEF repeatedly met with high-level leaders of the interim government and formally warned them that a shortage of vaccines would lead to an outbreak, complications, and increased mortality rates. This suggests that the authorities were aware of the risks in advance.
This raises the question: When the world considers measles vaccination crucial, why was there a long-standing delay in our country's vaccine acquisition system? Why were the authorities interested in the decision to procure 50 per cent of the vaccines through an open tender process? Even after learning from UNICEF that this decision could delay vaccine procurement by a year, why did they pursue this path? Policymakers had a responsibility to understand the difference between public health emergencies and bureaucratic processes. Why did they fail?
The interim government's health ministry was headed by close colleagues of Professor Yunus. Various irregularities, mismanagement, and decision-making issues during their tenure were highlighted in the media, but effective answers were never provided.
Now that international agencies have also criticised delays in vaccine procurement, the issue is no longer confined to political debate; it demands a full investigation in the public interest. Those who tried to escape accountability by citing the health advisor's poor health must explain why they held onto their positions.
Regardless of who was involved, the BNP government was not in power. However, since they have taken on the responsibility, the current government should promptly establish an independent and impartial investigative commission for the sake of transparency. National experts as well as representatives from international donor agencies could be included in the commission. The investigation should clarify who delayed the vaccine procurement, whose decision introduced the open tender process, at which level decisions were stalled, and how aware the top leadership was.
Accountability should not only focus on past investigations. The government must take more effective measures to address the current crisis. The number of child deaths is increasing due to the lack of urgent medical care, delays, and insufficient ICU facilities. Public hospitals have limited ICU facilities, especially for children. Pediatric ICUs need to be expanded in divisional and children's hospitals. Hospitals constructed in many areas have been unused for years and need to be operationalised.
In addition to public hospitals, treatment for children with measles must be ensured in private hospitals too, with special attention given to hilly regions and marginalised areas. Infected individuals should receive free treatment, necessary medicines, and isolation facilities. Compensation and psychological support should also be provided to families that have lost a child.
These child deaths due to measles are not inevitable natural events; the loss of life from a preventable disease indicates state failure. Therefore, there is no scope to avoid the questions of accountability, ensuring responsibility, and justice.
Most importantly, efforts should be made not to gain political advantage from child deaths but to view it as a public health catastrophe. When parents stand outside a hospital cradling the body of their deceased child, that child was not at fault. The blame for policy failure, indecision, or administrative delays cannot be placed on them.
These child deaths due to measles are not inevitable natural events; the loss of life from a preventable disease indicates state failure. Therefore, there is no scope to avoid the questions of accountability, ensuring responsibility, and justice.
On a positive note, at least the new government has recognised the gravity of the situation and taken urgent steps to procure vaccines and launch a campaign. However, once herd immunity is broken, immediate solutions are not possible with just vaccines. The impact could be long-lasting. It will take time to bring the infection fully under control. Hence, vaccination programmes need to continue uninterrupted, awareness needs to be increased, and special monitoring in high-risk areas is essential.
Our state must remember that each child's life is not just the future of a family but of a nation. No one can evade the responsibility of protecting that future. Let the full truth of this tragic measles outbreak be unearthed, bring those responsible to justice, and ensure no other family has to bear such grief in the future; that is now the demand of the nation.
Dr. Nadim Mahmud is a researcher, University of California
Email: [email protected]
#The opinions expressed are the author's own.
#This article, originally published in Prothom Alo online edition, has been rewritten in English by Rabiul Islam