A new policy brief warns that widening vaccination coverage gaps in Bangladesh could significantly increase the risk of antimicrobial resistance (AMR). Published by the Global Antibiotic Resistance Partnership (GARP), the brief states that vaccines play a critical role not only in preventing infectious diseases but also in reducing antibiotic use and slowing the spread of drug-resistant pathogens.

The policy brief, prepared under the leadership of the One Health Trust and icddr,b, places special emphasis on Bangladesh’s recent public health situation. Experts say disruptions in routine immunization programs and rising vaccine hesitancy in some areas are weakening population immunity. As a result, Bangladesh is facing one of its largest measles outbreaks in recent years. As of May this year, more than 51,500 suspected measles cases have been identified across the country, with over 350 reported deaths from confirmed and suspected infections combined.

The Link Between Vaccination and AMR

According to the policy brief, every preventable infection that is avoided also reduces the need for antibiotics, thereby lowering the risk of developing drug-resistant bacteria. Dr. Wasif Ali Khan, scientist at icddr,b and Chair of GARP-Bangladesh, said vaccines are among the most effective and cost-efficient tools for preventing infections. He noted that the current measles outbreak demonstrates how even small declines in vaccination coverage can threaten decades of public health progress.

AMR is now considered one of the world’s most serious public health threats. The brief estimates that between 2025 and 2050, AMR could cause more than 39 million deaths globally. In Bangladesh alone, around 96,878 deaths in 2021 were associated with AMR, including 23,454 deaths directly caused by antimicrobial resistance.

Bangladesh’s Progress and Emerging Concerns

The policy brief also highlights the success of Bangladesh’s Expanded Programme on Immunization (EPI). Through this program, the country has made significant progress in eliminating neonatal tetanus, controlling polio, and combating congenital rubella syndrome. However, experts stress that maintaining these achievements will require stronger vaccination coverage.

Dr. Eltа Kalanxhi, Partnership Director at the One Health Trust, said that although global efforts against AMR have focused heavily on surveillance, preventive measures must now receive equal importance. In her view, vaccination can become one of the central pillars of that prevention strategy.

Key Recommendations

The policy brief calls for ensuring universal childhood immunization, expanding access to effective vaccines that help prevent AMR, and integrating vaccination programs more closely into the national AMR strategy. It also recommends regular evaluation of the pneumococcal conjugate vaccine, continued long-term inclusion of the typhoid conjugate vaccine in routine immunization, and the rapid introduction of the rotavirus vaccine.

Representatives and experts from icddr,b, the Directorate General of Health Services, IEDCR, the University of Dhaka, the World Health Organization, UNICEF, and the Directorate General of Drug Administration contributed to the development of the policy brief. Experts warned that unless vaccination is treated as a central strategy in combating AMR, public health risks could grow even further in the future.