Bangladesh’s recent measles outbreak, with 130 deaths in six weeks, has sent shockwaves across South Asia, including in Nepal. As of April 7, the country’s Directorate General of Health Service reported over 9,500 suspected cases and 1,398 laboratory-confirmed cases. Children under the age of five make up 81 percent of these infections. Hospitals have seen hundreds of new patients daily, overwhelming both paediatric wards and critical care units. The tragedy appears to stem from the misuse of routine immunisation in recent years, which left many children vulnerable to this highly contagious disease. This serves as a wake-up call for Nepal, where measles continues to emerge despite the country’s commitment to eliminate it by this year. If Nepal doesn’t ramp up vaccination and awareness efforts, it risks going the Bangladesh way.

Nepal has repeatedly reported measles outbreaks since the beginning of this year. Last month, two rural municipalities in the Baglung district recorded a measles outbreak. In January, Sarlahi district in Madhesh province, which was declared fully immunised two years ago, also saw an outbreak, calling into question the officials’ claim of a ‘fully immunised province’. What’s common in these cases is that the vaccination status of most infected people was unknown; people cannot provide proof of vaccination, let alone confirm whether their children had been vaccinated against measles.

Vaccination is a lifesaver for diseases as deadly as measles. Measles was once endemic in Nepal, with an average of 90,000 cases recorded annually between 1994 to 2004, but cases have declined significantly since. Yet missing even a single dose is risky. To interrupt transmission, around 95 percent immunisation coverage with two doses is required. When people develop ‘herd immunity’, it prevents the spread of the disease. Inoculation interventions for vulnerable people are even more critical when outbreaks occur. Early detection and vaccination for those who haven’t taken a single dose are just as vital.

Yet despite ongoing outbreaks, health authorities have not launched a mass inoculation campaign in the two local units of Baglung district. Alarmingly, even the health facilities in places where measles is detected don’t have proof of immunisation. It has already been a month since the most recent outbreak in Baglung, but according to a recent report in this paper, there are no plans to start vaccination programmes soon. Vaccine scepticism and lack of awareness also prevent people from getting vaccinated, yet there have not been nearly enough awareness programmes. They also lack sufficient vaccine stock and budget to combat the disease.

A wait-and-see approach to deadly diseases such as measles is an indictment of systemic complacency that doesn’t sit well with an already struggling health sector. The stakes are too high because people of any age group can be infected with measles. Infants, pregnant women, elderly people and immunocompromised are most vulnerable. It can cause severe complications, even leading to death.

To be clear, measles is not an unbeatable disease; it has a well-established control strategy, which has long been followed by Nepal. By eliminating rubella in 2025, the country has already demonstrated that routine vaccination combined with robust surveillance is what we need the most. So it is vital to identify areas, particularly those with low vaccine coverage, such as marginalised communities, and launch robust vaccine and awareness campaigns. Investing in emergency response to diseases and in vaccine stockpiling should be another priority. The goal of eradicating measles is still within reach. What Nepal needs now is a political will to act.