Vaccine gaps could worsen antimicrobial resistance in Bangladesh, policy brief warns
In Bangladesh alone, 96,878 deaths were associated with antimicrobial resistance in 2021
A new policy brief released by the Global Antibiotic Resistance Partnership (GARP), led by the One Health Trust and icddr,b, highlights the critical role vaccines can play in reducing infections, lowering antibiotic use, and combating antimicrobial resistance (AMR) in Bangladesh.
Against a backdrop of widening immunisation gaps and the resurgence of vaccine-preventable diseases, evidence and recommendations provided in the brief are more pertinent than ever, according to a press release.
The brief, The Value of Vaccines in Mitigating Antimicrobial Resistance in Bangladesh, argues that vaccines should be recognised not only as tools to prevent infectious diseases, but also as a critical strategy to lower antibiotic use, slow the spread of drug-resistant infections, and protect public health in both the short and long term.
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The brief was developed as part of GARP's wider international initiative to communicate cross-disciplinary evidence on the role of vaccines in mitigating AMR in country-specific contexts. Countries currently participating in this effort include Bangladesh, Côte d'Ivoire, India, Kenya, Mozambique, Nepal, Pakistan, South Africa, Uganda, and Vietnam.
The Bangladesh brief was prepared through a series of consultations and reviews of national and global evidence involving experts from government agencies, research institutions, academia, development partners, and the wider One Health community, adds the press release.
The press release adds, "The brief comes at a critical moment for Bangladesh, which is currently experiencing one of its largest measles outbreaks in recent years. As of May, more than 51,500 suspected measles cases and over 350 confirmed and suspected deaths had been reported nationwide in 2026."
Public health experts say the outbreak reflects growing immunity gaps caused by disruptions in routine immunisation and declining vaccine confidence in some communities.
"Vaccines are among the most powerful and cost-effective tools available for reducing infections, lowering antibiotic use, and complementing broader efforts to combat antimicrobial resistance. Every infection prevented through vaccination represents a potential reduction in both antibiotic use and the emergence of resistant pathogens. Bangladesh's ongoing measles outbreak reminds us how quickly immunisation gaps can reverse decades of public health progress," said Dr Wasif Ali Khan, Scientist, Enteric and Respiratory Infections, Infectious Diseases Division at icddr,b and Chair of GARP-Bangladesh.
Globally, AMR is now recognised as one of the greatest public health threats of the century. According to estimates, AMR could cause more than 39 million deaths worldwide between 2025 and 2050.
In Bangladesh alone, 96,878 deaths were associated with AMR in 2021, while 23,454 deaths were directly attributable to AMR.
The policy brief acknowledges the significant progress Bangladesh has made through its Expanded Programme on Immunisation, which has helped eliminate neonatal tetanus, eradicate polio, and control congenital rubella syndrome over recent decades. However, it warns that those gains cannot be taken for granted.
Drawing on national and global evidence, the report shows that strengthening vaccine coverage could substantially reduce Bangladesh's AMR burden.
"The global response to AMR has focused heavily on surveillance, but prevention must become equally central to the conversation," said Dr Erta Kalanxhi, fellow and director of Partnerships at the One Health Trust.
The policy brief was developed collaboratively by the GARP-Bangladesh technical working group comprising multidisciplinary experts from icddr,b; Directorate General of Health Services (DGHS), Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh Medical University |(BMU), University of Dhaka, WHO, UNICEF, Directorate General of Drug Administration (DGDA), ARK Foundation, Bangladesh University of Health Sciences, and the livestock sector under a One Health approach.
Among its recommendations, the policy brief calls for sustaining universal childhood immunisation coverage, expanding access to vaccines with proven AMR benefits, and integrating vaccination more fully into Bangladesh's national AMR strategy. It also makes three vaccine-specific recommendations which could significantly reduce antibiotic use and the burden of AMR in Bangladesh: regularly evaluating the effectiveness of pneumococcal conjugate vaccines and transitioning to higher-valency formulations; ensuring the long-term integration of typhoid conjugate vaccine into routine immunisation; and accelerating the introduction of rotavirus vaccines.
The experts urge policymakers and public health leaders to use the recommendations and evidence presented in the report to strengthen immunisation efforts and make vaccines a more central part of Bangladesh's response to AMR.
