Rokan's Journal

Major General HRM Rokan Uddin (Retd)

Bangladesh is in the grip of a measles catastrophe that has shocked the global health community and exposed the devastating consequences of political negligence and institutional incompetence. As of May 19, 2026, 475 people have died from suspected measles symptoms, with 77 confirmed measles deaths, and more than 56,500 people have been recorded with suspected symptoms alongside nearly 8,000 confirmed cases. The overwhelming majority of victims are children under the age of five. What makes this tragedy so difficult to absorb is not its complexity but its simplicity: measles has a safe, effective, decades-old vaccine. Every single death was preventable.

Since early January 2026, the country has seen a surge in measles cases with thousands of suspected infections and a rising number of deaths, with what is particularly concerning being where this outbreak began and continues to intensify – the Rohingya refugee camps in Cox’s Bazar. Home to more than 1.2 million Rohingya refugees in the world’s largest refugee settlement, Cox’s Bazar presents overcrowded and precarious living conditions that dramatically increase the likelihood of rapid transmission among an already vulnerable population. Among confirmed measles patients in the camps, around three-quarters were unvaccinated. The camps were sparks. But the tinder had been accumulating for years across the entire nation, and it was the decisions of successive governments – both elected and unelected – that ensured it would eventually ignite.

Bangladesh was, until recently, a genuine public health success story. Since the nationwide expansion of the Expanded Programme on Immunisation in 1985, the country built one of the region’s most respected vaccine delivery systems. Supplementary measles-rubella campaigns, systematic outreach, and the introduction of a routine second dose in 2012 pushed the country close to measles elimination and sharply reduced the disease burden. Between 2014 and 2015, nationwide measles-rubella campaigns vaccinated over 50 million children, and by the mid-2010s, more than 92% of children received the initial vaccine dose. International health organisations cited Bangladesh as a model for low-income countries. That reputation, built painstakingly over a generation, has now been destroyed.

The most direct cause of the 2026 outbreak lies in a catastrophic policy decision made by the interim government of Muhammad Yunus, which came to power after the ouster of Prime Minister Sheikh Hasina following mass protests in 2024. In September 2025, the Yunus government halted vaccine procurement through UNICEF and moved to an open tender system. UNICEF strongly opposed the change, warning it might disrupt the immunization system. “For God’s sake… don’t do this,” UNICEF’s Bangladesh representative Rana Flowers recalls telling interim health minister Nurjahan Begum. The tender process got mired in bureaucratic delays and vaccine supplies dried up, leading to nationwide stockouts. A supplemental measles-rubella immunization campaign, originally planned for 2024 but postponed because of political unrest, was cancelled entirely. Government figures indicated that by late March 2026, only 59% of eligible children had received measles vaccinations in 2025 – far below the threshold required to prevent outbreaks. That data was later quietly removed from the government’s website.

The procurement collapse did not happen in isolation. The Health, Population and Nutrition Sector Programme – a framework in place since 1998 — was scrapped in March 2025 without an adequate exit plan. Bridging projects meant to cover the transition were not approved until November 2025, and it took several more months to appoint project directors. Over 14,000 community clinics across the country saw their medicine supplies dwindle as a result. Two additional campaigns – for deworming tablets and Vitamin A supplements – also remained suspended for over a year, a disruption experts believe worsened children’s vulnerability to severe measles complications. Meanwhile, health workers went on strike three times during 2025, and some evidence suggests that vaccinations were being falsely reported from the field, inflating official coverage statistics and masking the true scale of the immunity gap.

When confronted with their role in this disaster, officials of the interim administration retreated into bureaucratic language and deflection. Prof Sayedur Rahman, special assistant to the chief adviser for health, said officials were “not accustomed to the new system” and that “bureaucratic inertia” caused the delays. He claimed that UNICEF’s warning had only reached him on December 30, 2025, leaving little time to act. He further stated the government had been preoccupied with treating wounded protesters from the July uprising. These explanations landed with the public like petrol on fire. Warnings of declining coverage had been sounded by epidemiologists long before December. Among confirmed measles patients, 74% had received neither dose of the vaccine while 14% had received only one – these are children who fell through a gap the health ministry itself created and then failed to close.

Subsequent elections in early 2026 brought Tarique Rahman and the Bangladesh Nationalist Party to power. Addressing Parliament, Prime Minister Tarique Rahman acknowledged the severity of the shortage and squarely blamed both the previous Hasina government and the interim Yunus administration for policy failures that contributed to the crisis. For many citizens, however, the political blame-trading felt obscene against the backdrop of children dying in overwhelmed hospital wards. International human rights organisations noted that what was unfolding was not merely a health crisis but a grave human rights issue, where the most fundamental right – the right to life of children — was being compromised by the state. The International Society for Human Rights called on the government to open an independent inquiry and establish individual accountability, noting that the pattern of neglect and delayed response had allowed a preventable outbreak to escalate into a national emergency.

The response, when it came, was significant but belated. In the weeks following the emergency declaration, nearly 18 million children were reached with at least one dose of the vaccine. International organisations including the IRC launched emergency vaccination campaigns in the Rohingya refugee camps, targeting 20,000 children across multiple camps and adjacent host communities. Procurement rules were reverted and emergency vaccine supplies were secured through UNICEF. For hundreds of grieving families, these measures were too late by months.

What this crisis ultimately demands are not just emergency response but structural reckoning – a set of lessons that Bangladesh and nations in similar positions cannot afford to ignore. The most urgent is that public health infrastructure is not a political instrument. Every incoming government, elected or interim, must treat functioning health programmes as sovereign assets to be maintained rather than restructured for ideological or administrative reasons. When a system built over decades is dismantled without a credible replacement, the consequences are measured in children’s lives. Vaccine procurement continuity is life-critical, and buffer stocks exist for a reason. Supplementary immunisation campaigns cannot be treated as optional or deferred indefinitely – Bangladesh had not conducted a nationwide measles-rubella campaign since 2020, and that gap directly contributed to the accumulation of unvaccinated children who became the fuel for this outbreak. Early warnings from international bodies must be acted upon urgently, not filed away or minimized. Marginalized populations – refugees, residents of informal urban settlements, children in remote districts – require dedicated, sustained strategies rather than afterthought inclusion. And health workers must be valued, paid fairly, and supported, because a demoralized workforce cannot deliver a functioning immunisation program regardless of how well the policy is written on paper.

The 2026 resurgence reflects accumulated immunity gaps rather than biological vaccine failure. It is a system failure – and therefore a human failure. Bangladesh once brought measles under control through a program that became an international model. It is unconscionable that infants are now dying from this disease due to gaps in routine immunisation. The political debates raging in Dhaka offer nothing to the mothers who have buried their children. What they leave behind – what this catastrophe demands – is a political culture willing to place the lives of its youngest citizens above administrative convenience, institutional pride, and the perpetual score-settling of a fractured political class. Bangladesh built a vaccination legacy that took a generation to construct. Whether it has the will to rebuild it honestly, and to hold those responsible to genuine account, will define what kind of nation it chooses to be.