In Bangladesh, the Expanded Programme on Immunization (EPI) has been a significant achievement in public health. Through government commitment, strong partnerships, and a network of health workers, it effectively reduced vaccine-preventable diseases, positioning the country as a model for others.
However, recent challenges indicate a decline in the immunization system. National vaccination coverage dropped to 60% in 2025 from previous levels of 85-92% between 2010 and 2022. This decline is not sudden but reflects deeper issues in governance rather than just logistical problems.
The disruption of vaccine procurement under the Health, Population and Nutrition Sector Programme (HPNSP) in 2025 without a proper transition plan is a critical policy failure. This decision lacked technical consultation and risk assessment, leading to delayed approvals and funding uncertainties.
Misinformation and vaccine hesitancy have also contributed to the crisis, exacerbated by a lack of public communication and counter-engagement. The Typhoid Conjugate Vaccine campaign in 2025 saw refusal rates rise due to misinformation, pushing coverage below herd immunity thresholds in urban areas.
Structural weaknesses in the system, such as vacant EPI field-level positions and unpaid vaccine porters, have further strained the immunization program. Data systems also show gaps in coverage, particularly in urban areas, highlighting the need for improved visibility and intervention strategies.
Similar challenges are seen in family planning, with workforce shortages, procurement issues, and institutional weakening leading to contraceptive stockouts in many regions. The inability to protect essential public health systems from administrative disruptions poses a significant risk to national health.
To address these issues, restoring institutional stability, improving procurement processes, filling workforce gaps, investing in research, and rebuilding public trust through communication are crucial. Ensuring continuity in health systems amid policy shifts is essential to prevent further crises.
The current trajectory threatens to undo decades of progress in Bangladesh’s health sector. A course correction is necessary to avoid long-term setbacks and safeguard public health systems from future crises.
