Bangladesh is battling measles. It’s a ‘real warning’ to other nations

[Bangladesh Struggles With Record Measles Outbreak; Weak Response Highlights Global Implications]

SYLHET, Bangladesh: Bangladesh is battling a severe measles outbreak that experts describe as a critical ‘real warning’ to other nations about the deadly risks posed by declining immunization rates.

Bangladesh, whose routine vaccination program faltered in 2025, reported 202,000 suspected measles cases—22,000 of them laboratory‑confirmed—since the outbreak began in mid‑March and continued through October 9, the World Health Organization reported. This totals more suspected cases than any other country this year.

To date, 1,147 people have died of the highly contagious disease, with 94 percent of reported deaths occurring among children under five, the WHO stated.

Bangladesh’s experience illustrates the difficulty of controlling an outbreak when vaccination coverage falls below the 95 percent threshold, a level the WHO identifies as necessary to achieve herd immunity.

The nation’s immunization progress declined sharply last year; while it once served as a vaccination success story, routine coverage for the first dose reached 96 percent and the second dose only 93 percent—and both numbers plummeted to 90 percent and 86 percent of targets respectively in 2025—well below the safe benchmark.

A Reuters review of WHO documents combined with interviews with dozens of scientists, health workers, and officials reveals that Bangladesh was hampered in its emergency response by incomplete data missing millions of children, preparation shortcomings, and failures to reach sufficient parents.

“This is a real warning to every country,” said Mark Jit, a WHO vaccine adviser and professor at NYU’s School of Global Public Health.

Preventing an outbreak through vaccination proved easier, cheaper and safer than managing a full‑scale emergency, he added.

“The response will stop the outbreak eventually, but in the meantime many will have had measles, and some will have died,” he explained.

Prime Minister Tarique Rahman’s special assistant Ziauddin Hyder told Reuters in September that the government was doing everything it could to end the outbreak; however, the government did not address additional questions asked in October for this article.

‘THEY CAME ONLY AFTER I BURIED MY SON’

In the northeastern Sylhet region, one of the national hotspots in a population of 178 million, two‑year‑old Arman Hossain died unvaccinated in July, 24 hours after being admitted to hospital for treatment that he had paid for by selling his family’s three‑wheeled auto rickshaw. His unvaccinated four‑year‑old sister survived.

His father Amin Mia, 26, stated that no health workers came to their remote village to offer vaccinations in time. “They arrived only after I buried my son,” he said.

While measles typically claims two or three deaths per thousand cases, the illness can prove deadlier in poorer nations due to factors such as malnutrition.

In the town of Chhatak, also in Sylhet, 30‑year‑old carpenter Humayun Rashid’s nine‑month‑old daughter, Labiba Akter, died unvaccinated in June. She could have received an inoculation in April when an emergency program temporarily lowered the vaccination age from nine months down to six months.

“No health worker came to tell us,” her father said.

In May, Health Minister Sardar Md. Sakhawat Husain announced that the emergency drive had reduced hotspot cases to near zero and that the outbreak was under control.

Yet by September, Bangladesh reported a daily average of 1,198 new measles cases—the highest total since May.

The outbreak gains urgency as vaccine hesitancy rises in wealthier nations, fueled by skepticism from figures such as U.S. Health Secretary Robert F. Kennedy Jr.

In Bangladesh, access to inoculations and public awareness present the greater obstacles, according to experts.

Only a few years ago, Bangladesh was hailed as a vaccination success story. The WHO and UNICEF estimated that in 2024 the nation achieved 96 percent coverage for the first dose and 93 percent for the second—numbers that fell sharply during 2025 political unrest.

That same year saw protests derail fifteen years of Rule of Prime Minister Sheikh Hasina, leading to health workers going on strike, delayed vaccine orders, and disrupted follow‑up shots normally part of routine programs.

A July report by the WHO and UNICEF indicated that first‑dose coverage in 2025 had dropped to 90 percent and second‑dose coverage to 86 percent—several percentage points below the 95 percent required for herd immunity.

The report also flagged concerns about the quality of official vaccination data for 2023‑2025, noting that preliminary figures sometimes exceed 100 percent of targeted recipients—a sign of counting errors or misrepresented targets.

EMERGENCY PROGRAMME MISSED MILLIONS

Despite the rapid, initially successful launch of an emergency response that saw nearly 20 million children receive a vaccine in April and May—claiming coverage of every child in the six‑months‑to‑five‑years age group—the program ultimately fell short.

The deficit became evident when another routine health intervention in June carried a target list of 4 million additional children beyond the measles campaign itself, yet the same age group remained unaffected.

“There is a gap,” said prime ministerial adviser Hyder to Reuters on September 14, citing parental vaccine hesitancy or children’s illnesses as reasons children stayed home.

Further challenges have emerged as well.

Document reviews examining meetings held in April and August between the government, the WHO, and partner health agencies revealed how the push for speed compromised preparedness measures.

Minutes from the April 19 meeting described the choice to conduct only one round of readiness checks instead of the usual four—covering refrigeration integrity, dosage calculations, and staffing—to meet tight timelines.

The single‑round assessment concluded that most—but not all—districts appeared prepared, though comprehensive checks remain essential for catching gaps early.

THE POOREST ‘PAY THE PRICE’

“When preparedness checks are not performed correctly, the poorest and hardest‑to‑reach children often bear the brunt of missed vaccinations,” said Professor Mahmudur Rahman, an epidemiologist and chair of Bangladesh’s National Verification Committee for Measles and Rabella Elimination.

Hyder clarified that the April emergency campaign was launched in just four weeks, whereas immunization drives typically require months of planning. Tajul Islam Abdul Bari, who formerly led immunization efforts until 2017, remarked that typical campaigns demand considerably longer lead times.

By the eighth month, sessions identified persistent coverage gaps; the proportion of children with confirmed measles who were unvaccinated stayed virtually unchanged—rising only slightly from 82 percent pre‑campaign to 85 percent post‑campaign.

The WHO declined to answer questions about the April and August meetings, though Deputy WHO representative to Bangladesh Dr. Rajesh Narwal affirmed the agency’s commitment to supporting the government’s goal of vaccinating every at‑risk child.

“Routine immunization must become more effective and resilient so that these gaps do not develop again,” he stated.

In Sylhet, where official records list 180 child deaths, eight of sixteen families interviewed by Reuters in September reported never having seen health workers offer vaccinations. At least six families said health workers arrived only after a child in their community had died from measles.

By late September, the government launched a new campaign targeting 3.4 million previously missed children and pledged to engage communities so no child would be left behind, according to the health minister.

Nevertheless, reaching every child continues to pose obstacles. UNICEF and the Bangladesh Bureau of Statistics indicate that up to 40 percent of children remain unregistered, while government statistics reveal roughly one‑third of health worker positions are vacant.

Experts also urge expansion of vaccination to children older than five, who represent a third of overall measles cases per the WHO.

Research underway in Bangladesh seeks to explain why immunity wanes more rapidly in infants up to six months of age, a period when maternal antibodies normally still provide protection.

Ensuring prompt medical care remains critical, especially as Bangladesh simultaneously contends with a dengue epidemic.

In September, every ward of Sylhet’s 100‑bed Shahid Shamsuddin Ahmed Hospital—treating measles—appeared overwhelmed. During the Reuters visit, 178 patients had been admitted.

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