Measles resurgence highlights policy gaps and system failures: Experts

Despite the availability of vaccines, weaknesses in planning, coordination, and last-mile service delivery have contributed to the ongoing measles situation, speakers at a recent policy dialogue underscored.

Raising urgent concerns about the country's primary healthcare capacity, the experts identified critical gaps in policy, financing, and healthcare delivery systems.

The dialogue, organised by the Power and Participation Research Centre (PPRC) on Saturday night, focused on the dual challenges of policy and management behind the measles outbreak. Moderated by PPRC Executive Chairman Hossain Zillur Rahman, the session brought together public health experts to assess systemic shortcomings and propose solutions.

Dr Tajul Islam Bari, a vaccinologist and public health specialist, traced the crisis back to policy and financing issues. He noted that significant funds had been allocated for vaccine procurement between July 2025 and June 2026, including government resources and support from an Asian Development Bank-backed Covid-19 vaccine facility.

However, despite approvals allowing joint procurement with Unicef, delays in file clearance stalled implementation. He emphasised that while vaccines were sufficiently available, poor distribution management and failures in last-mile delivery prevented them from reaching service points effectively.

Highlighting the clinical impact, Dr Syeda Humaida Hasan from Chittagong Medical College Hospital reported a sharp rise in measles cases. Between April 1 and April 18, the hospital recorded over 226 suspected cases, mostly among children from low-income and malnourished backgrounds living in overcrowded conditions. Many patients were either unvaccinated or partially immunised, pointing to an urgent need for a nationwide measles-rubella vaccination campaign. She also noted a stark increase in severe cases compared to previous years, when critical cases remained relatively low.

Dr Md Aminul Hasan, Founder and CEO of Quality Care Concern, linked the outbreak to broader disruptions in the immunisation system. He explained that the closure of the long-standing sector programme in June 2024, without a proper transition plan, created significant gaps. The shift to a project-based approach exposed weaknesses in procurement, supply chains, and service delivery. He added that delays in transitioning from Unicef-supported procurement to government-managed systems further exacerbated supply issues due to procedural and approval constraints.

Dr Mohsin Zillur Karim of Aamra Community Hospital pointed to widespread panic among parents, which has affected both healthcare-seeking behaviour and clinical management. He said that in many cases, fear-driven decisions led to delayed diagnosis, over-treatment, and inappropriate care, contributing to avoidable complications and deaths. He stressed the importance of community awareness and coordinated local action.

Concluding the session, Dr Hossain Zillur Rahman emphasised that addressing the current crisis must remain the immediate priority while also recognising deeper systemic failures in ensuring primary healthcare as a fundamental right. He stressed strengthening routine immunisation and expanding awareness at both community and family levels through coordinated local and national efforts, involving social organisations and development partners.

He called for a "creative resilience" mindset in society to address complex public health challenges, while highlighting institutional gaps where vaccine availability failed to ensure effective distribution due to the absence of a proper transition plan, underscoring the need for rigorous supply chain analysis. He also stressed establishing primary healthcare as a constitutional right and strengthening routine immunisation as a key public awareness priority for long-term health resilience