Nepal is facing a resurgence of measles across multiple districts at a time when vaccine stocks are insufficient to mount a full emergency response, raising fears among health experts that the country could be heading towards a crisis of the kind currently devastating Bangladesh.
Outbreaks have been confirmed in seven districts since January, infecting over 300 children, with Baglung district alone accounting for more than 200 of those cases. Despite the spread, emergency vaccination drives have been limited to Sarlahi district and Dhorpatan Municipality in Baglung, because there are not enough doses to carry out ring vaccinations across all affected areas.
The comparison with Bangladesh is not made lightly. Nepal’s neighbour has been battling an ongoing measles outbreak since mid-March that has killed more than 500 children, a catastrophe that experts link to disruptions in routine immunisation following the country’s political upheaval in 2024, when the interim government halted vaccine procurement through UNICEF, depleting stocks and leaving millions of children unprotected.
Health officials in Kathmandu are warning that Nepal is drifting in the same direction. Contract health workers and vaccinators have reportedly been cut by the new government, and vaccine procurement has not been prioritised despite repeated outbreaks. Nepal currently has neither vaccine buffer stocks for outbreak response nor a dedicated budget for emergencies, and assistance from aid agencies has become slower and less reliable. The Health Ministry recently received 200,000 doses from an aid agency, several months after requesting emergency supplies, but even those are insufficient to cover all affected areas.
The setback is a significant one for a country that had set itself an elimination target. Nepal had aimed to eradicate measles by 2026, having recorded no outbreak since June 2023, but the current resurgence has derailed that ambition. The country had previously missed elimination deadlines in both 2019 and 2023, and experienced a major outbreak across 2022 and 2023. Elimination requires confirmed cases to fall below five per million people per year, with no new outbreaks for three consecutive years verified by independent international assessors.
Measles is preventable with a standard two-dose vaccine given at nine and fifteen months of age, provided free of charge at health facilities across the country. However, low vaccination coverage, high population mobility, weak public awareness and official complacency in plugging gaps have allowed the disease to persist in pockets of poor and marginalised communities. Experts say it is precisely those communities that must be prioritised if Nepal is to avoid the trajectory its neighbour is now experiencing.