The measles outbreak now sweeping through Bangladesh has claimed the lives of hundreds of children, with the country's health ministry reporting over 1,500 confirmed deaths since January. The true number is likely far higher, as many cases go unregistered in rural areas where access to healthcare is minimal. This is not a natural disaster. It is a direct consequence of disrupted vaccination programmes during the COVID-19 pandemic, compounded by a strained health system and vaccine hesitancy.
Measles is a highly contagious virus that, in a malnourished or unvaccinated child, can cause severe complications including pneumonia and encephalitis. The World Health Organisation had declared measles eliminated in Bangladesh in 2014, but routine immunisation coverage has fallen from 97% to 83% in the last three years. This reduction, while seemingly small, is catastrophic. Measles has a basic reproduction number of 12 to 18, meaning each infected person can spread it to more than a dozen others in a susceptible population. The loss of herd immunity opens a wide corridor for rapid transmission.
Hospitals in Dhaka, Chittagong, and Sylhet are overwhelmed. Field reports describe children with high fever, Koplik spots, and the characteristic blotchy rash, often accompanied by diarrhoea and dehydration. Many arrive too late for supportive care. The mortality rate among hospitalised children is estimated at 5%, but in remote communities without access to vitamin A or antibiotics, it can exceed 10%. This is preventable death on a scale that should provoke global urgency.
The Bangladesh government, with support from UNICEF and the WHO, has launched an emergency vaccination campaign targeting 14 million children under five. However, logistical challenges are immense. Flooding, political instability, and a shortage of cold storage for vaccines are slowing progress. Meanwhile, the virus continues to spread through cities and villages alike. The gap between the number of children vaccinated and the number needed to stop transmission is closing too slowly.
This outbreak is a stark reminder that public health infrastructure is not a static achievement. It must be maintained and funded. The pandemic diverted resources and attention, leaving a void that measles has exploited. The lesson is plain: when routine immunisation falters, diseases once suppressed return with a vengeance. For the children of Bangladesh, that vengeance is now measured in thousands of small graves.
As a climate correspondent I am sometimes asked: what does this have to do with the environment? Everything. A warming planet exacerbates malnutrition, water scarcity, and displacement, all of which undermine health. But this outbreak is not driven by climate change. It is driven by failures in health governance and international solidarity. We cannot blame the weather for our collective neglect. The tools to prevent this exist. They simply were not used in time.
The global community must act now to support Bangladesh's vaccination drive, but also to strengthen health systems worldwide. The next outbreak could be in your neighbourhood. The only question is whether we will be prepared.
