Measles Outbreak

Bangladesh is battling the world’s largest reported measles outbreak this year, with 1,147 deaths since March and children under five accounting for 94 per cent of the toll. According to the WHO, the country has recorded more than 202,000 suspected cases, including 22,000 laboratory-confirmed infections. For a country once regarded as a regional success story in childhood immunisation, the figures make for a distressing read.

The trouble began when routine immunisation faltered amid political upheaval, healthcare workers’ strikes and disrupted vaccine supplies. By 2025, first-dose coverage had slipped to 90 per cent and second-dose coverage to 86 per cent, well below the 95 per cent needed to prevent outbreaks. Even an emergency campaign reaching nearly 20 million children failed to contain the epidemic.

Worse still, official records excluded millions of children, while some vaccination figures exceeded 100 per cent of the estimated target population. In remote communities, families reported receiving little assistance until the disease had taken its toll. With roughly 40 per cent of children unregistered and a third of healthcare positions vacant, the gaps were hardly surprising.

The international retreat from public-health financing has made matters worse for vulnerable countries. The dismantling of USAID has crippled health programmes worldwide. In Pakistan, the American aid freeze threatened more than 60 health facilities serving 1.7 million people. Washington also withheld $600 million from Gavi, the global vaccine alliance, before releasing the funds in July. Bangladesh’s outbreak may have its own documented causes, yet shrinking international assistance leaves poorer health systems with little room for error.

Closer to home, Pakistan has no reason to regard this as Bangladesh’s problem alone. The WHO recorded 20,741 measles cases here last year. Estimated first-dose coverage stood at 84 per cent and second-dose coverage at 83 per cent. Four major Karachi hospitals reported 1,915 cases and 125 associated deaths during the first seven months of 2026. The disease has already found plenty of room to spread.

That said, the government’s nationwide measles-rubella campaign last November, targeting 34.6 million children, still deserves credit. Frontline vaccinators have worked under difficult circumstances, often travelling considerable distances to reach vulnerable communities. Yet occasional campaigns cannot make up for weaknesses in routine immunisation.

Provincial health authorities should reconcile vaccination registers with birth records, strengthen district-level surveillance and trace children who have missed their doses. Independent verification of coverage figures is equally important. With international assistance drying up, greater domestic investment in immunisation can scarcely wait.

Bangladesh’s experience shows how quickly years of progress can go down the drain when basic healthcare services are neglected. Pakistan has already paid dearly for gaps in polio vaccination. It can scarcely afford another preventable disease gaining ground while officials congratulate themselves on meeting targets. *