EPI Clinic, Mahakhali, Dhaka

 

The success achieved by Bangladesh in immunisation through EPI is a testament to the government’s commitment to ensuring high-quality healthcare services for its citizens. The country has received numerous accolades, including the “GAVI Best Performance Award” in 2009 and 2012; and the prestigious “Vaccine Hero” award for Prime Minister Sheikh Hasina in 2019 [2]. Through immunisation, Bangladesh has prevented an estimated 2 million deaths between 1987 and 2000, and it continues to prevent around 200,000 deaths each year. One of the biggest reasons for this success is the Expanded Programme on Immunisation (EPI), which has been in operation since 1979 and has seen vaccination coverage increase from 16% in 1988 to over 90% in 2019 [3].

The World Health Organisation (WHO) launched the EPI programme in Bangladesh in 1979 to reduce morbidity and mortality from Vaccine-Preventable Diseases (VPDs) by providing high-quality immunisation services to all children. The programme started with six vaccines, and with extensive support from the government, it expanded its operations to cover 476 upazilas, 92 major municipalities, and 6 city corporations by 1990 [4]. During this time, the programme set up more than 134,000 outreach centres throughout the country with advanced cold storage facilities to ensure high-quality vaccine coverage [1]. In subsequent years, the government introduced newer and improved vaccines, such as the TT5 dose, Measles Containing Vaccines, Pneumococcal Conjugate Vaccine, and Injectable Polio vaccines. The success of these continuous efforts was reflected in the eradication of Polio from the country, and Bangladesh was certified as a Polio-free country by WHO in 2014 [5].

Despite these successes, Bangladesh now faces numerous unique challenges regarding the containment of VPDs. Maintaining high coverage for immunisation is a continuous struggle as the vaccine production levels must align with the growing population. Immunisation inequalities have also been a major concern, and high internal migration has contributed to a lack of traction of Zero-dose or children who missed the first dose of the pentavalent vaccine, which may result in re-emerging diseases [6]. However, Gavi, the Vaccine Alliance, has extended its immunisation support for Bangladesh until 2027 and is looking into further extending its support to help the government meet new challenges [7]. Additionally, the government is taking numerous steps to address these issues, including increasing the budget for the health sector as well as research and innovations for better vaccine production.

The success of immunisation in Bangladesh has not only saved millions of lives but has also served as an inspiration to other countries. The country’s commitment to eradicating vaccine-preventable diseases has been unwavering, and its approach to ensuring accessibility to all children, regardless of their socioeconomic background, has been commendable. The EPI has become a model programme for other countries looking to improve their immunisation coverage and reduce VPDs. While challenges remain, the government’s continued efforts and support from organisations such as Gavi, the Vaccine Alliance will ensure that Bangladesh remains a leader in the fight against VPDs.

  1. “NATIONAL immunisation POLICY.” Directorate General of Health Service, 20 Nov. 2013, Gov.bd. [cited 2023 Apr 15]. Available from: http://old.dghs.gov.bd/images/docs/EPI/National%20immunisation%20Policy%20Bangladesh%20November%2020th%202013.pdf 
  2. UNB, New York. PM receives ‘Vaccine Hero’ award [Internet]. The Daily Star. 2019 [cited 2023 Apr 15]. Available from: http://www.thedailystar.net/frontpage/news/pm-receives-vaccine-hero-award-1804831 
  3. Sarkar PK, Sarker NK, Doulah S, Bari TIA. Expanded Programme on immunization in Bangladesh: A success story. Banglad J Child Health [Internet]. 2017 [cited 2023 Apr 15];39(2):93–8. Available from: https://www.banglajol.info/index.php/BJCH/article/view/31540 
  4. Ministry of Health and Family Welfare, Bangladesh. “EPI Coverage Evaluation Survey (CES) 2019.” Directorate General of Health Services, 2019, Gov.bd. [cited 2023 Apr 15]. Available from: http://old.dghs.gov.bd/images/docs/vpr/Coverage_Evaluation_Survey_2019.pdf 
  5. Bangladesh polio free [Internet]. The Daily Star. 2014 [cited 2023 Apr 15]. Available from: http://www.thedailystar.net/bangladesh-polio-free-17528 
  6. “Immunisation Advocacy Brief: LEAVING NO CHILD BEHIND: Scaling up Investment in immunisation to Protect against Diseases.” Unicef.org. [cited 2023 Apr 15]. Available from: https://www.unicef.org/bangladesh/media/5271/file/Immunization%20Advocacy%20Brief%20final.pdf.pdf 
  7. “MPs Urge Gavi to Continue Funding Bangladesh’s immunisation Programme.” The Business Standard, 6 Sept. 2022, Tbsnews.net. [cited 2023 Apr 15]. Available from: http://www.tbsnews.net/bangladesh/health/mps-urge-gavi-continue-funding-bangladeshs-immunisation-programme-491242 
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