Measles crisis exposes cracks in Bangladesh's health system: Report

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Bangladesh's health sector, shaped over decades, risks being undone within years unless corrective steps are taken, a report has highlighted.

According to Bangladesh's leading newspaper 'The Daily Star', the current measles vaccine crisis in the South Asian nation is not merely an isolated disruption but reflects institutional weakening, with national vaccination coverage dropping to around 60 per cent in 2025 - the lowest in nearly a decade - from 85-92 per cent between 2010 and 2022.

"Bangladesh's Expanded Programme on Immunisation (EPI) has long been one of the country's most celebrated public health successes. Built on sustained government commitment, strong development partnerships, and a vast network of frontline health workers, it delivered consistently high coverage and sharply reduced the incidence of vaccine-preventable diseases. For years, it positioned the country as a model for the developing world. That model is now being undone," the report detailed.

The report stressed that such a significant decline in vaccine coverage is not merely a logistical problem but a clear failure of governance.

Immunisation systems, it said, rely on predictable structures - "coordinated procurement, stable financing, functioning leadership, and a reliable workforce" - and when these elements are disrupted - especially at the same time - the system collapses.

"For years, vaccine procurement operated under the Health, Population and Nutrition Sector Programme (HPNSP), which provided a clear and functional administrative pathway. Its effective dismantling in 2025, without a credible transition mechanism, represents a critical policy failure. There is little evidence that this decision was guided by broad technical consultation or risk assessment, an omission that is difficult to justify given the stakes," it mentioned.

The report noted that structural weaknesses within the system are equally stark, with nearly 45 per cent of EPI field-level positions in 37 districts lying vacant.

"These workers operate across roughly 150,000 vaccination centres, which are the backbone of the immunisation programme. Without them, coverage declines are inevitable. Meanwhile, vaccine porters responsible for maintaining the cold chain reportedly went unpaid for months, triggering unrest and nationwide strikes. A system that cannot sustain its frontline workforce cannot sustain its outcomes," it stated.

The report emphasised the need to "restore institutional stability, re-establish clear procurement pathways, urgently fill workforce gaps, invest in research and surveillance, and rebuild public trust" through consistent communication.

Highlighting the broader risks, it warned, "Just as importantly, critical health systems must be insulated from abrupt policy shifts and administrative discontinuity. If addressed now, the broader system stress remains manageable. If not, they will escalate into crises that are far more costly, both financially and in human terms."

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