Protecting our children from Measles: Leadership, facts, and decisive action

As of 8am today (31 March), a total of 2,268 children have been hospitalised with suspected measles, including 168 new admissions. Of these, 684 cases have been confirmed by the laboratory.

In addition, according to the DG Health MIS report, 16 child deaths with measles-like symptoms have been reported as of 30 March. However, it is important to note that none of these deaths have yet been laboratory confirmed as measles-related, and further clinical investigation is required to determine the exact causes. 

These figures indicate an increasing outbreak that requires urgent attention, while also underscoring the importance of distinguishing suspected, probable, and confirmed cases as well as deaths in public communication. 

Measles is a highly contagious viral disease that primarily affects children and spreads rapidly through respiratory droplets. Its symptoms include high fever, cough, runny nose, red eyes, and a characteristic skin rash. 

In severe cases, it can lead to pneumonia, diarrhea, malnutrition, and even death, particularly among unvaccinated or undernourished children.

This situation cannot be taken lightly. It reflects deeper systemic challenges within our health system, including problems that did not emerge overnight. Once a child is infected with measles, vaccines can no longer play a preventive role. 

Therefore, proper case management becomes critical. Ensuring adequate nutrition and hydration, controlling fever, maintaining hygiene, and providing a comfortable environment are essential. 

Vitamin A supplementation is particularly effective in reducing complications, especially those affecting the eyes and respiratory system. Prompt treatment of complications such as pneumonia or diarrhea is vital, and antibiotics may be used in cases of secondary infections. 

Isolation of infected children is also important to prevent further spread. Even in the absence of vaccines, timely and appropriate care can significantly reduce measles-related mortality.

Looking at immunization trends over recent years, coverage remained relatively stable between 2017 and 2024, ranging roughly from 86% to over 100% for certain antigens. 

However, in 2025, coverage dropped sharply to approximately 59.6%, which is clearly a significant warning signal. This means a large number of children have either missed vaccination or are only partially protected. 

Compounding this issue, Bangladesh has not conducted a national Measles-Rubella (MR) campaign since December 2020-January 2021. In public health practice, periodic campaigns are essential to close immunity gaps that routine immunisation cannot fully address. 

Without such campaigns, the number of susceptible children accumulates year after year, eventually reaching the size of an entire birth cohort. That accumulated risk is now manifesting as increased vulnerability to outbreaks.

Field-level challenges during the past regimen have further complicated the situation. Prolonged strikes and work stoppages by health assistants, along with irregular Vitamin A campaigns, have weakened child health protection. 

These issues were exacerbated by the inefficiency, inexperience, and delayed decision-making of the previous government, which disrupted service delivery at the grassroots level. 

Poorly planned policy transitions without adequate readiness led to coordination breakdowns and interruptions in critical programs. Vitamin A shortages, in particular, increase the risk of severe measles complications, making the situation more concerning.

Policy-level operational mistakes from the past have also contributed to the current crisis. The previous government abruptly replaced the operational plan (OP) and line director system with a DPP-based approach without adequate readiness. This created financing and implementation bottlenecks within the Ministry of Health. 

Furthermore, although Tk850 crore was allocated for vaccine procurement, only 50% was assigned for direct procurement through UNICEF, while the remaining 50% was to be procured through the Central Medical Store via competitive tendering. 

Due to lack of experience in international vaccine procurement, this process has not even begun, leading to nationwide vaccine stock-outs.

What we are witnessing today is therefore the cumulative effect of long-standing policy gaps, planning weaknesses, and implementation failures. 

The absence of regular immunization campaigns, weak leadership and strategic planning, fragmented vaccine supply systems, and inadequate human resource management at the field level have all contributed to this situation. These are not recent developments, but rather the delayed consequences of past inefficiencies and poor governance.

There is, however, reason for cautious optimism. The government is preparing to launch an MR campaign urgently, an essential and timely intervention. Under the leadership of Prime Minister Tarique Rahman, the government has already demonstrated strong commitment to removing past bottlenecks. 

Efforts are underway to expedite vaccine procurement through direct contracting with UNICEF, including pre-financing, ensuring rapid replenishment of vaccine stocks. At the same time, rebuilding supply systems, reactivating frontline health workers, and strengthening Vitamin A programs are being prioritized.

Most importantly, we must move away from panic and toward evidence-based analysis. Every child's life matters. But misinformation and premature conclusions can worsen the situation.

Bangladesh can overcome this challenge. The BNP-led government, through its commitment, decisive leadership, speedy decision making and implementation efficiency, has already shown its capacity to act. With timely decisions, coordinated planning, and rapid execution, this crisis can be brought under control. 

The government's resolve and capability to do so are clear.

Dr Ziauddin Hyder is an Adviser to the Chairman, Bangladesh Nationalist Party and a former Senior Health and Nutrition Specialist of World Bank Group.

Disclaimer: The views and opinions expressed in this article are those of the author and do not necessarily reflect the opinions and views of The Business Standard.