Bangladesh is grappling with the largest measles outbreak globally, with the World Health Organization confirming 202,000 suspected cases and 1,147 deaths, 94% of them children under five, since March. The surge follows a drop in routine vaccination coverage in 2025, where first‑dose rates fell to 90% and second‑dose to 86%, below the 95% herd‑immunity threshold. Though officials claimed the emergency drive had reduced hotspots "almost to zero" in May, September saw a daily average of 1,198 new infections, the highest since May, highlighting persistent gaps.
Key developments include the launch of a late‑September campaign targeting 3.4 million missed children, with the health minister pledging village‑level outreach to ensure no child is left behind. However, systemic challenges remain: up to 40% of children are unregistered, roughly a third of health‑worker posts are vacant, and data gaps obscure the true scale of the crisis. Researchers are also investigating accelerated waning of maternal antibodies in infants under six months, complicating protection efforts.
Why it matters: The outbreak underscores the critical importance of maintaining >95% vaccination coverage to prevent measles resurgence, serving as a cautionary tale for countries experiencing vaccine hesitancy. The high child mortality rate threatens Bangladesh’s public‑health gains and places additional strain on a health system already coping with a concurrent dengue epidemic.
What to watch next: Monitoring the effectiveness of the new vaccination drive, especially in reaching unregistered children; WHO and UNICEF assessments of any improvements in coverage rates; and potential policy shifts to expand immunisation to children over five, who now account for a third of cases. Continued data transparency and the filling of health‑worker vacancies will be pivotal in curbing the outbreak. [[1]]