Bangladesh is facing soaring measles cases not because of a single localized failure, but because of years of systemic erosion. Ultimately, maintaining herd immunity against highly contagious viruses requires relentless attention to supply and demand, as well as to the broader social and institutional foundations of public health.
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DHAKA—Once on the brink of elimination in many parts of the world, measles has made a troubling global comeback in recent years, with approximately 10.3 million cases in 2023, up 20% from 2022. While outbreaks have been concentrated in Africa, the Eastern Mediterranean, Southeast Asia, and the Western Pacific, high-income countries have also experienced a resurgence, with the United States reporting 1,983 confirmed cases this year alone. These experiences highlight a painful truth of public health: even the most successful immunization programs are vulnerable to erosion.
