THE current state of immunisation in Bangladesh, which, introduced in 1979, has failed to achieve a full coverage as yet, is worrying. The UN Children鈥檚 Fund, the World Health Organisation, and the vaccine alliance Gavi have said that about half a million children continue to miss out on full immunisation; about 400,000 of them are under-immunised. At the same time, 70,000 have received no vaccines at all. The disparity is more pronounced in urban areas, with only 79 per cent of full vaccination, 2.4 per cent with no dose at all and 9.8 per cent under-immunisation. In rural areas, 85 per cent coverage has, however, been achieved. The persistent gaps point to likely inadequacy in policy and implementation has not addressed emerging urban vulnerabilities. Yet, the Expanded Programme of Immunisation continues to yield significant benefits, saving an estimated 94,000 lives and preventing five million child illnesses each year, with an impressive return of $25 for every $1 invested. Bangladesh has progressed to 81.6 per cent full immunisation coverage from a mere 2 per cent since its inception.
Now, if the opportunity to reach every child is missed, child mortality rates could increase, overshadowing decades of progress. And, it will ultimately burden the public health severely. Challenges remain in reaching every child as many face compound vulnerabilities such as poverty, lack of education and poor access to health care. Persistent barriers to full immunisation include human resource constraints, wide gaps in coverage in urban slums and limited access in hard-to-reach areas. With Bangladesh set to graduate out of the least developed countries status in November 2026, the forthcoming transition away from Gavi support would be a serious setback. The government will then need to fully finance the immunisation programme, including vaccine procurement, policy development, cold chain equipment and vaccination implementation. Experts say that reaching every child would require continued investments in innovation and an active outreach. The organisations, therefore, call on the government to strengthen and sustain its immunisation efforts by reaffirming high political commitment, ensuring adequate human resources and budget, closing the gaps in urban coverage, securing vaccine supply chains and scaling up human papillomavirus vaccination. Better monitoring and outreach have also been recommended as a critical step towards making the programme more effective and inclusive.
The authorities should, therefore, address the problems with urgency and cover as many children as possible before the LDC graduation. Authorities should also address the gaps in the immunisation programme immediately. An expanded coverage can only reduce burden on public health and ensure that no child is left behind.
