A nationwide measles outbreak in Bangladesh has infected more than 32,000 people and claimed over 250 lives, mostly children, since mid‑March.
According to the journal Science, the crisis has been linked to disruptions in the country’s immunization system following a shift in vaccine procurement policy.
The crisis emerged after the interim government moved vaccine procurement away from Unicef to an open tender system in September 2025, a decision that led to delays, nationwide shortages, and gaps in routine immunization coverage.
At hospitals across the country, the human toll is stark.
On April 7, Konika Akter lay on the floor of Dhaka Shishu Hospital and Institute, crying out for mercy as her husband, Mohammad Zakir, stood beside her in visible grief.
Their six-month-old daughter, Ruhi, lay in a measles ward, having been transferred to the same intensive care unit bed where her twin sister, Risa, had died earlier that day.
“How can I bury the one who looks just like her?” Zakir said.
Bangladesh, a country of more than 175 million people that has long maintained high vaccination rates, is now grappling with one of its most severe public health crises in recent years.
The outbreak has reached 58 of the country’s 64 districts and led to more than 21,000 hospitalizations.
Hospitals, including Dhaka’s Infectious Disease Hospital, have reported overcrowded wards, with some children treated on floors due to bed shortages.
Globally, measles has been resurging, with outbreaks reported in North America, Europe, the Middle East, and Africa.
Experts attribute this to vaccine hesitancy, disruptions during the Covid-19 pandemic, and conflict-related healthcare breakdowns.
However, in Bangladesh, the outbreak has been tied primarily to systemic failures in vaccine procurement and delivery.
The political backdrop has further complicated the situation.
Former prime minister Sheikh Hasina was ousted following a 2024 uprising marked by widespread protests and the deaths of hundreds of students.
An interim government led by Nobel laureate economist Muhammad Yunus subsequently took office and introduced reforms, including changes to vaccine procurement.
The decision to halt procurement through Unicef and adopt an open tender system was met with strong opposition from international partners.
Rana Flowers, Unicef’s representative in Bangladesh, said she repeatedly warned officials of the risks.
“For God’s sake … don’t do this,” she recalled telling interim health minister Nurjahan Begum, who did not respond to questions from Science magazine.
The tender process became entangled in bureaucratic delays, causing vaccine supplies to dwindle.
Routine immunization programs were disrupted, and a planned measles-rubella campaign, originally scheduled for 2024 but postponed due to political unrest, was ultimately canceled.
By late March, government data showed that only 59% of eligible children had received measles vaccinations in 2025, far below the 95% threshold required to prevent outbreaks.
The data were later removed from official websites.
The outbreak was first detected in January in Rohingya refugee camps near the Myanmar border before spreading nationwide.
In a April 23 update, the World Health Organization warned of a “considerable risk” of cross-border transmission to Myanmar and India, describing the situation as a reversal of Bangladesh’s progress toward measles elimination.
Underlying vulnerabilities have worsened the crisis.
Malnutrition remains widespread, with 28% of children under five stunted and 10% suffering from wasting.
Vitamin A deficiency, which weakens immune systems, has also increased risks, compounded by the country missing three consecutive vitamin A distribution campaigns since 2024, according to ASM Alamgir, former principal scientist at the Institute of Epidemiology, Disease Control and Research (IEDCR).
Health infrastructure constraints have added to the strain.
“Beyond immunization gaps, Bangladesh’s measles crisis reflects deep structural weaknesses,” said Mohammad Mushtuq Husain, an adviser at IEDCR.
The newly elected government, which assumed office on February 17, has begun taking corrective measures.
In April, it reinstated vaccine procurement through Unicef and coordinated with the World Health Organization and Gavi, the Vaccine Alliance, to secure supplies, according to Ziauddin Hyder, special assistant on health affairs to Prime Minister Tarique Rahman.
Authorities launched an emergency vaccination campaign on April 5 targeting children aged six months to five years in high-risk areas, followed by a nationwide rollout on April 20.
Plans are also underway to resume vitamin A distribution.
Despite these efforts, experts caution that the outbreak may not subside quickly.
“At this rate of vaccination, the infection will not decrease right now,” said Be-Nazir Ahmed, former director of disease control at the Directorate General of Health Services.
Calls are growing for stronger government action.
Husain has urged authorities to formally declare a public health emergency to accelerate response measures.
“This is already an emergency,” he said. “So why hesitate to officially declare a public health emergency?”
The crisis has also triggered political and legal scrutiny.
During a parliamentary session, Prime Minister Tarique Rahman attributed responsibility to both the previous administration and the interim government.
In response, Sheikh Hasina, now in exile in India after being sentenced to death in absentia, said in an email to Science.org that her government had prioritized vaccination and avoided major measles outbreaks during her tenure.
Legal challenges have also emerged.
On April 12, Supreme Court lawyer Biplob Kumar Das filed a complaint with the Anti-Corruption Commission, alleging corruption and mismanagement in vaccine procurement under the interim administration.
Unicef’s Flowers said the procurement decision should be investigated given its consequences.
Sayedur Rahman, former vice chancellor of Bangladesh Medical University and a health adviser to the interim government, defended the policy shift, saying the previous system relied on emergency provisions and required reform.
He said the move aimed to establish a “regular, rule-based system” to improve transparency.
However, he acknowledged the human cost.
“The loss of children to a fully preventable disease like measles is heartbreaking,” Rahman wrote.
“It is a human tragedy, and my deepest condolences go to every family that has suffered.”
