Vaccine gaps could worsen AMR risks

A new policy brief has warned that vaccine gaps could worsen antimicrobial resistance (AMR) in Bangladesh amid the ongoing measles outbreak, which experts say has been driven largely by low immunisation coverage.

The Global Antibiotic Resistance Partnership (GARP), led by One Health Trust and icddr,b, released the policy brief recently.

The policy brief, titled "The Value of Vaccines in Mitigating Antimicrobial Resistance in Bangladesh," said vaccines should be viewed not only as tools to prevent infectious diseases, but also as a key strategy to reduce antibiotic use, slow the spread of drug-resistant infections, and safeguard public health in both the short and long term.

The brief was developed as part of GARP's broader international initiative aimed at communicating cross-disciplinary evidence on the role of vaccines in addressing AMR in country-specific contexts.

Countries participating in the initiative include Bangladesh, Côte d'Ivoire, India, Kenya, Mozambique, Nepal, Pakistan, South Africa, Uganda and Vietnam. The brief comes at a time when Bangladesh is facing one of its largest measles outbreaks in recent years. Since mid-March, suspected measles infections have risen to 59,279, while confirmed cases reached 8,275 as of Thursday.

Public health experts said the outbreak reflects widening immunity gaps caused by disruptions in routine immunisation programmes and declining vaccine confidence in some communities.

"Bangladesh's ongoing measles outbreak reminds us how quickly immunisation gaps can reverse decades of public health progress," said Dr. Wasif Ali Khan, scientist at the Enteric and Respiratory Infections unit under the Infectious Diseases Division of icddr,b and chair of GARP-Bangladesh.

Globally, AMR is now recognised as one of the century's biggest public health threats. According to estimates cited in the brief, AMR could cause more than 39 million deaths worldwide between 2025 and 2050.

In Bangladesh alone, 96,878 deaths were associated with AMR in 2021, while 23,454 deaths were directly attributable to drug-resistant infections.

Drawing on both national and global evidence, the report said strengthening vaccine coverage could significantly reduce Bangladesh's AMR burden.

"The global response to AMR has focused heavily on surveillance, but prevention must become equally central to the conversation," said Dr. Erta Kalanxhi, fellow and director of partnerships at the One Health Trust.

The policy brief was developed collaboratively by the GARP-Bangladesh technical working group comprising multidisciplinary experts from icddr,b; Directorate General of Health Services (DGHS), Institute of Epidemiology, Disease Control and Research (IEDCR), Bangladesh Medical University (BMU), University of Dhaka, WHO, UNICEF, Directorate General of Drug Administration (DGDA), ARK Foundation, Bangladesh University of Health Sciences, and the livestock sector under a One Health Trust approach.

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