There has been a fresh spike in both dengue and measles cases, hospitalisations, and deaths this month (October), which is happening despite a three-month dengue control drive and an intensified measles catch-up vaccination campaign launched by the government in September. The dengue death toll crossed the 400 mark recently, with more than 128,000 patients hospitalised around the country so far this year.

Meanwhile, a recent study of measles vaccination, led by the state-run Institute of Epidemiology, Disease Control and Research (IEDCR), has found that 27.5 percent of children receiving the jabs this year have not developed antibodies. Children aged 9 to 14 months are particularly affected. The findings do not, by themselves, establish why immunity failed to develop.

However, this ineffectiveness is only one side of the story; immunisation gaps, depleted vaccine stocks in 2025, delays in catch-up campaigns, and serious staffing shortages-as found by a joint independent review-have led to where we stand today, with more than 1200 measles-related deaths till date. A similar pattern is evident in dengue control. Public health experts have criticised the lack of year-round mosquito surveillance, targeted elimination of breeding sites, and properly trained field workers.

The World Health Organization, UNICEF, Gavi, the Vaccine Alliance, and other institutions are supporting the government's efforts. A 70-member expert team was formed earlier this month to review the country's immunization programme.

The expert team identified several serious shortcomings, including full immunization coverage of only 82% among children, below the national target of 95%. Nearly 40% of vaccination worker posts are also vacant.

Bangladesh had long been regarded as a successful example of an immunization programme. Since the Expanded Programme on Immunization (EPI) began in 1979, the country had eliminated polio and tetanus, while rubella and hepatitis B had also been brought under control.

Recent declines in vaccination coverage have again placed children at risk from serious infectious diseases. The healthcare system's foundations were also found to be eroding. About 53 percent of cold-chain technician posts are vacant, as are 34 percent of health assistant and inspector posts in the field and 45 percent at the programme's headquarters. Some 90 percent of vaccinators in urban areas work for NGOs, with little oversight. A vaccinators' strike disrupted services for seven months last year. The review blames governments of every stripe, of which the authorities should take note. The coverage gaps predate the current government and persisted under both the Awami League and the interim administration. The present government has also responded too slowly and too narrowly.

Rather alarmingly, the situation as it now exists has prompted national and international experts to warn of possible outbreaks of diseases that were close to being eradicated from the territory of Bangladesh, such as diphtheria, whooping cough and polio - in the near future, unless conditions improve rapidly. It remains to be seen whether the government takes these dire projections seriously, and if so, what measures they are able to implement towards averting that doomsday scenario.