Letter shows UNICEF warning Yunus government of looming measles vaccine crisis

Shifting to open tender system may prolong vaccine procurement process, writes UNICEF representative

UNICEF had warned the Muhammad Yunus-led interim government of a looming vaccine shortage in Bangladesh months before the crisis deepened, an official correspondence letter has shown.

In a letter sent on Feb 10, two days before the parliamentary election, UNICEF Representative in Dhaka Rana Flowers urged former health advisor Nurjahan Begum to take immediate action to avoid a “major vaccine crisis”.

“You directed me to raise with you directly key concerns,” Flowers wrote at the start of the letter.

“And I write now to express sincere concern regarding the now very likely outcome that Bangladesh will face a severe shortage of vaccines, unless urgent steps are taken.”

Under the subheading titled “Imminent risk of vaccine stock-outs”, the letter said the validity of the MR5 measles-rubella vaccine had expired on Feb 5, while stocks of bOPV polio vaccine, tetanus and diphtheria (TD) vaccine, and BCG vaccine for tuberculosis were set to expire on Feb 15, Feb 22 and Feb 28, each.

Apart from those four vaccines, the first shipment of other vaccines had been “well used”, Flowers wrote, adding that the “ADB APVAX agreement” needed to be finalised urgently and funds transferred to procure MR5, bOPV and BCG vaccines.

The UNICEF representative said the agency’s supply division had previously arranged advance financing twice to prevent stock depletion.

UNICEF Bangladesh also played a role in negotiations to ensure no child died while waiting for the initial 50 percent revenue budget allocation.

“Given UNICEF's network and system, a minimum of two months only is required for the standard procurement cycle from fund transfer to shipment,” the letter said.

“But I fear that any further delay, particularly in finalising the APVAX agreement-will significantly heighten the risk of delay and stock-outs.”

Flowers also reminded the government that five vaccines, including measles-rubella shots financed jointly with support from Gavi, must be procured through UNICEF.

The letter detailed how shifting to an open tender system could prolong the process.

“I understand that the Ministry this year has moved to apply the Open Tender Method (OTM) for the remaining 50 percent of the revenue budget,” Flowers wrote.

Referring to earlier instructions from the health advisor, she warned that procurement through open tenders could take eight to 10 months, creating an “almost guaranteed risk of childhood illness and death” due to vaccine shortages.

Attempts to contact former advisor Nurjahan and former chief advisor’s special assistant on health Sayedur Rahman for comment were unsuccessful, as calls went unanswered and text messages received no response.