Nisikhola and Badigad Rural Municipalities of Baglung district reported a measles outbreak around a month ago but vaccination against the disease has not started yet, raising fear of further spread.

Health officials admit that the government neither has vaccines in stock for outbreak response nor a plan to start vaccination immediately.

“We don’t have measles vaccines in stock for outbreak response,” said Dr Abhiyan Gautam, chief of the Immunisation Section at the Family Welfare Division under the Department of Health Services. “We used doses from the routine immunisation programme to vaccinate vulnerable children in the disease-hit areas of Malangawa and Dhorpatan. But we cannot continue diverting vaccines purchased for routine programmes.”

Measles is a highly contagious disease transmitted through respiratory droplets from the nose and mouth of an infected person. It can be potentially deadly for unvaccinated people.

The current outbreak in Nisikhola is the fourth since the start of 2026. Health officials say a suspected outbreak has been reported from Koshi province and is in the process of verification.

Immunisation experts say all vulnerable people should be vaccinated immediately to help control the outbreak. They say that the absence of a vaccination drive even a month into the outbreak, and no plans to start soon, exposes serious gaps in the country’s disease control system. Multiple outbreaks in a short span also indicate low immunisation coverage and wide vaccination gaps.

Officials say there is no dedicated budget to buy vaccines for outbreak response, and aid agencies also have yet to provide requested doses. Vaccination in the disease-hit areas of Malangawa Municipality and Dhorpatan Municipality is not enough to stop the spread elsewhere, they say.

“All vulnerable children of disease-hit areas should be vaccinated, “ said Gautam, the chief of the Immunisation Section. “We had planned to cover all eligible children in the entire Malangwa Municipality, as well as in Nisikhola and Badigad rural municipalities, but could not proceed due to a shortage of doses.”

Officials said they had requested the Measles & Rubella Partnership, a global alliance of major international organisations working to eliminate measles and rubella, for vaccine doses. Although the alliance has assured help, officials say it is not clear when the vaccine will arrive.

Health officials say that aid agencies, which in the past responded swiftly to outbreaks, have not shown such readiness in recent years, possibly due to their own funding constraints.

“This kind of negligence raises questions on our commitment to eliminate the deadly disease from the country,” said Dr Shyam Raj Upreti, an immunisation expert, who is also former director general of the Department of Health Services. “The new government must ensure funding for outbreak response through the budget.”

As the new government has committed to increase funding in the immunisation programme and eliminate the disease from the country, it cannot cite funding crunch or lack of support from aid agencies as an excuse for delayed response, Upreti said.

Low vaccination coverage, a floating population, lack of public awareness of the importance of vaccines, and apathy among government agencies in plugging loopholes are among the reasons for the regular outbreaks of measles across the country, according to experts.

Nepal aimed to eliminate measles by 2026, as there had been no outbreak since June 2023. However, recent outbreaks in Baglung and Sarlahi have hindered the country’s progress towards meeting the goal.

The country earlier missed the 2023 and 2019 deadlines. Major measles outbreaks occurred in 2022 and 2023.

To declare measles eliminated, cases must be fewer than five per 1,000,000 people per year. The country must verify progress through foreign, independent verification. For independent verification, there should be no new outbreak for three consecutive years, officials say.

Doctors say people of all age groups are vulnerable to measles. Underage children, pregnant women, elderly people and those with weak immunity, such as HIV-infected people, are highly susceptible to the disease.

Early symptoms, which usually appear 10-12 days after infection, include high fever, runny nose, bloodshot eyes and white, tiny spots inside the mouth. Several days later, rashes develop on the face, upper neck and other parts of the body. Some people may experience severe complications, such as pneumonia and encephalitis, and these diseases may also cause death.

The disease can be prevented with a two-dose vaccine, administered to babies at 9 months and 15 months. The government provides measles vaccines free of charge at health facilities across the country.

Measles was endemic in Nepal, and an average of 90,000 cases were recorded every year from 1994 to 2004. Routine measles vaccination began in the country in 1979, starting with three districts. The campaign was made nationwide after 10 years.