Government Disregards Expert Measles Recommendations

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DHAKA – Bangladesh’s Health Ministry and Directorate are facing criticism for allegedly failing to implement crucial recommendations from expert committees tasked with combating a widening measles outbreak, prompting concerns over communication and coordination within the health sector. The recommendations, including the formation of a multi-sectoral oversight committee, were put forth after a joint meeting of top health experts on April 12.

Health Minister Sardar Md. Sakhawat Hossain, speaking to Prothom Alo on April 23, stated he was unaware of the experts’ recommendation for a new committee, adding he had not been informed.

The outbreak, which began spreading in the second week of March, led to the first joint meeting of two key expert committees on April 12. Chaired by renowned scientist Firdausi Qadri, who also leads the National Immunization and Technical Advisory Group (NITAG), the meeting aimed to devise strategies against the escalating health crisis. NITAG, comprising 15 members, independently advises the government on vaccination matters, with its current committee formed under the interim government with a mandate until July 30, 2025.

Also present at the meeting was Professor Mahmudur Rahman, former director of the Institute of Epidemiology, Disease Control and Research (IEDCR) and chairperson of the National Verification Committee for Measles and Rubella Elimination (NVC). The NVC, a nine-member body formed by the Health Ministry in November 2017, assesses Bangladesh’s progress towards measles and rubella elimination and advises both the government and the World Health Organization’s regional commission.

According to minutes signed by Dr. Qadri, the joint session specifically recommended the formation of a multi-sectoral committee. This proposed body would include child health specialists, epidemiologists, virologists, laboratory experts, and other relevant professionals, tasked with prioritizing disease detection and guiding evidence-based decision-making. This committee has yet to be established.

The meeting’s deliberations also emphasized careful planning to address measles, effective communication strategies to contain its spread, and ensuring high-quality implementation of programs.

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While these recommendations were being made, vaccination efforts were already underway. A campaign began on April 5 in 30 high-risk areas across the country. On the day of the joint meeting, April 12, vaccinations commenced in Dhaka South, Dhaka North, Barisal, and Mymensingh city corporations, marking the national rollout of the immunization campaign. The experts, however, called for robust observation of this vaccination drive.

Public health experts familiar with the April 12 discussions, who requested anonymity, expressed disappointment over the perceived inaction. One expert pointed to a “lack of dynamism” among officials at the Health Directorate and the Expanded Program on Immunization (EPI). Another lamented the fact that the Health Minister was reportedly not informed of the experts’ recommendations. Efforts to obtain comments from Health Directorate Director General Professor Probhat Chandra Biswas over the past two days were unsuccessful. Furthermore, the EPI lacks a designated chief spokesperson, as its primary official, a deputy director, was made an Officer on Special Duty (OSD) on April 9.

In response, Md. Kamruzzaman Chowdhury, Secretary of the Health Services Division at the Health Ministry, told Prothom Alo that the ministry is “working sincerely and not sitting idle.” He stated that many initiatives began even before NITAG’s meeting and recommendations, including the rapid rollout of vaccination. He added that the process to form the expert-recommended committee is underway.

However, other technical issues discussed by the experts, such as defining and implementing isolation protocols for specific types of patients and ensuring measles vaccination for children in Rohingya refugee camps in Cox’s Bazar district, have seen no reported action.

Public health expert Abu Jamil Faysal criticized the overall situation, describing it as indicative of “negligence and indifference.” He told Prothom Alo that the apparent disconnect—experts making recommendations, the minister being unaware, and the recommendations remaining unimplemented—highlights a clear “lack of communication and coordination.” Faysal deemed such a situation “reprehensible” amid an urgent measles crisis.