Red tape cited for interim govt's measles vax fiasco
Senior health officials from the interim government, speaking anonymously, cite bureaucratic hurdles and the country’s withdrawal from the sector programme as key challenges
Delays in vaccine supply caused by the open tender system during the rule of the interim government are contributing to the country's ongoing measles outbreak, says a recent report published in Science.org, while health officials from the period blame bureaucratic complexities for the situation.
The report yesterday (2 May) stated that a policy shift by the interim government in vaccine procurement contributed to a measles outbreak that has killed over 250 children across Bangladesh.
The Business Standard spoke to several senior health officials of the previous interim government. Speaking on condition of anonymity, they pointed to bureaucratic complications and the country's exit from the sector programme.
Keep updated, follow The Business Standard's Google news channel
The Health, Population and Nutrition Sector Programme (HPNSP) was launched in 1998 with donor support as a five-year initiative. With financial support from Gavi, vaccines were procured by EPI through Unicef, a process that was relatively faster and less complex.
One former official said the current problem did not arise from policy decisions or fund allocation, but from prolonged administrative bottlenecks and delays at the implementation stage.
He said the government had allocated around Tk1,400 crore for vaccine procurement. "However, despite the allocation, procurement was not completed on time. Files were returned multiple times, and even re-tendering became necessary."
He said multiple agencies, including the Planning Commission and the Ministry of Finance, prolonged the process by applying their own procedural requirements. "We submitted the full proposal, but only partial approval was given. Implementation of even that part took several more months."
Even after approval from the Cabinet Committee on Economic Affairs, fund release took additional months, delaying vaccine supply.
He further said that even after approval, fund disbursement and procurement through international agencies took several months. Unicef, he noted, did not begin shipment before receiving payment.
The official added that no early warning about a possible measles outbreak was received from Unicef, Gavi, the EPI, or any public health experts. "Had there been such a forecast, the emergency vaccination campaign could have been advanced," he said.
He also said a three-member inquiry committee was formed on 21 September 2025 to investigate responsibility for the failure to procure vaccines on time, despite approvals being in place.
Another EPI official, speaking anonymously, said over Tk1,000 crore had been allocated for the period from July 2025 to June 2026. Of this, about Tk421 crore was initially sent to Unicef, but the full procurement process was only completed by April this year.
He further explained that complications arose when the government attempted to move away from direct procurement through Unicef to a new procurement mechanism.
"When an ongoing system is abruptly replaced, it takes time to stabilise the new process. If a transition period of two to three years had been given, this crisis could have been avoided," he said.
Exit from sector programme
Public health expert Dr M Mushtuq Hussain told TBS that although the decision to exit the sector programme may have been well-intentioned, shutting down the existing framework without preparing an alternative created operational complications.
He said public health priorities did not receive adequate attention amid administrative focus on procedural compliance. "In trying to follow rules, an urgent public health situation was overlooked."
After the interim government assumed office, it decided to abolish the sector programme. Following several meetings, the programme was formally scrapped at a meeting on 6 March 2025. The system of procuring vaccines through operational plans was also discontinued.
At one stage, the ministry decided to exclude Unicef from vaccine procurement, but the Ministry of Finance raised several objections. Unicef was subsequently re-included in the procurement process. These back-and-forth decisions led to delays of several months.
Meanwhile, as the hospitals see an inflow of children with admitted measles or similar symptoms, the Directorate General of Health Services (DGHS) said four children died from measles-like symptoms between 8am on Friday (1 May) and 8am yesterday (2 May).
During the period, 1,024 patients with measles-like symptoms were admitted to hospitals across the country. Of these, 72 cases were confirmed as measles through laboratory testing.
So far this year, at least 49 children have died from confirmed measles infections in Bangladesh. In addition, 235 children have died showing symptoms consistent with measles.
DGHS data also shows that 39,325 suspected measles cases have been reported nationwide this year. Of them, 23,225 patients have already been discharged after receiving treatment.
What Sayedur Rahman says
The Science report quoted Dr Md Sayedur Rahman, then chief adviser's special assistant for health ministry, who defended the interim government, saying the earlier system relied on emergency provisions and that the interim government aimed to establish a more "rule-based" and transparent procurement process.
Responding to the report, Sayedur told The Business Standard that his comments had been presented in a "fragmented" manner, which could create confusion.
He said no changes were made to Bangladesh's vaccine procurement process during the tenure of the interim government, rejecting claims of a policy shift linked to the recent measles outbreak.
He added that vaccines under the EPI, particularly those fully financed by the government such as measles vaccines, were procured under the Public Procurement Act 2006.
"Under the law, procurement was carried out through the direct procurement method (DPM) or open tender method (OTM)."
Sayedur, a former vice-chancellor of Bangladesh Medical University said the health ministry, in December 2024, sought approval for vaccine purchases, after which the Advisory Council Committee on Economic Affairs allowed procurement through DPM until June 2025 under a special provision citing urgent public interest.
He noted that while internal discussions were held on shifting toward more competitive and transparent methods such as OTM or long-term agreements, no such process was initiated
