Nearly nine in ten families affected by Bangladesh’s measles outbreak have borrowed money for treatment costs, while six in ten exhausted savings, turning a preventable disease into a crushing financial crisis for the poor.

Bangladesh’s ongoing measles outbreak has exacted a heavy human and economic toll, with a new assessment revealing that nearly nine in ten affected families have been forced to borrow money and six in ten have wiped out their savings to cover treatment-related expenses. 

The findings from a field study undertaken by the Bangladesh Red Crescent Society underscore how a disease once on the path to elimination has resurfaced as both a public health emergency and a driver of household impoverishment, particularly among low-income communities.

The crisis stems from a sharp drop in measles-rubella vaccination coverage, compounded by earlier vaccine shortages linked to procurement delays, budget shortfalls, and disruptions following political changes. Coverage that had hovered near or above 90 per cent in previous years fell dramatically in 2025, with first- and second-dose rates dipping below 60 per cent in some data, leaving large cohorts of children unprotected. Measles, one of the most contagious diseases, requires around 95 per cent two-dose coverage for herd immunity. Gaps allowed the virus to spread rapidly from mid-March 2026 onward.

Government figures have recorded tens of thousands of confirmed and suspected cases, with hundreds of deaths – mostly among children under five years of age. Hospitals in Dhaka and elsewhere have been overwhelmed, with wards far exceeding capacity and families travelling long distances for care. Complications such as pneumonia, encephalitis, and severe malnutrition frequently require prolonged hospital stays, intensive care, and medicines that must often be purchased outside public facilities.

Catastrophic Costs Hit the Poorest Hardest

Treatment expenses quickly become catastrophic. Families report spending 20,000 to 40,000 Takas at government hospitals for a typical episode, with private intensive-care costs soaring into the hundreds of thousands of Taka. Even in public facilities, parents frequently buy medicines, diagnostics, oxygen, nebulizer supplies, and food for attendants. Indirect costs compound the burden: parents lose wages while remaining at the bedside for weeks, and travel by ambulance from rural areas can alone cost 10,000 to 16,000 Taka.

An earlier economic study of measles in children under five in Bangladesh found that caregivers bore the bulk of costs. Average economic costs to households reached $131 to $182 (in 2018 dollars) per hospitalised case, representing on average 32 per cent of monthly household income. Nearly 90 per cent of caregivers spent more than 10 per cent of monthly income on treatment; many faced catastrophic health expenditure, defined as spending that pushes households toward or into poverty. The poorest quintiles were hit hardest, with 78 per cent experiencing catastrophic costs compared with 21 per cent of the richest. Coping strategies relied heavily on savings, loans from banks or informal lenders, and borrowing from relatives or friends.

The current outbreak has amplified these patterns. Out-of-pocket spending already accounts for roughly 69 to 79 per cent of total health expenditure in Bangladesh, leaving little buffer for sudden shocks. Parents describe exhausting savings, closing small businesses, and taking high-interest informal loans – sometimes at annual rates exceeding 100 per cent – simply to keep treatment going. In one widely reported case, a shopkeeper spent nearly 600,000 Taka on care for twin sons who ultimately died; another family borrowed 30,000 Taka for a single child’s week-long hospital stay.

Real Stories of Debt and Loss

Across hospital corridors in Dhaka, parents recount similar trajectories. A rickshaw-van driver borrowed 25,000 taka from a neighbour at punishing interest after his infant son developed complications. A mother from Pabna spent her savings plus borrowed funds totaling 30,000 Taka. Families from distant districts arrive exhausted after multi-hour journeys, only to face daily outlays for supplies not fully covered by public hospitals. Some report sleeping on floors or going hungry to stretch limited cash. Income loss is near-universal while a child remains hospitalised; many fathers cannot work for weeks or months.

These individual hardships aggregate into a broader economic burden. Earlier calculations for a much smaller number of cases already showed hundreds of thousands of dollars in societal costs. With tens of thousands of hospitalisations in the current wave, total out-of-pocket expenditure has been estimated in the hundreds of millions of taka, even using conservative government-hospital averages. The poorest households, already spending a higher share of income on healthcare, face the greatest risk of long-term debt traps, reduced food and education spending, and descent into or deeper into poverty.

Systemic Gaps and the Path Forward

Experts attribute the resurgence to accumulated immunity gaps: missed routine doses, cancelled or delayed supplementary immunisation campaigns, vaccine stock-outs in 2024–25, and lower coverage in urban poor and certain rural areas. Malnutrition, overcrowding, and high rates of low-birth-weight babies among disadvantaged groups further increase severity and mortality. Public health specialists note that many children became ill before the age of routine vaccination (nine months for the first dose), highlighting both transmission intensity and the need for broader protection strategies.

Authorities have responded with emergency measles-rubella vaccination campaigns, reaching millions of children, and by converting facilities and expanding dedicated beds. Bangladesh’s international partners including UNICEF, WHO, and Gavi have supported vaccine supplies and outbreak response. 

Cash assistance from non government organisations has helped some families continue treatment after savings and loans ran dry. Yet experts emphasise that sustained high coverage  – above 95 per cent for two doses – remains essential to prevent future waves. Strengthening routine immunisation, ensuring reliable vaccine supply chains, reducing out-of-pocket costs through better public provision of medicines and diagnostics, and addressing underlying malnutrition are repeatedly cited as priorities.

The human cost is measured not only in deaths and hospital beds but in emptied savings accounts, mounting informal debts, shuttered small shops, and children whose recovery is shadowed by family financial ruin. Measles is preventable. The current outbreak demonstrates how quickly progress can reverse when immunisation systems falter – and how the economic consequences fall most heavily on those least able to bear them. Restoring robust vaccination coverage and shielding households from catastrophic health spending are urgent both for public health and for social equity, the study report notes.