Typhoid is a highly contagious infection that typically causes high fevers of up to 39-40 degrees Celsius, along with symptoms such as headache, cough, extreme fatigue, constipation, loss of appetite and diarrhea. If left untreated, there are risks of intestinal and neuropsychiatric complications. The cause of the disease is the bacteria S. typhi, and the primary mode of transmission is through food or water that is undercooked or contaminated from contact with an infected individual.

Typhoid in Bangladesh

Typhoid in Bangladesh is endemic. In fact, there were approximately 477,518 cases of typhoid, with 7,998 deaths in 2021. According to a 2017 study, Bangladesh is one of the top five countries worldwide in terms of clinical incidence, deaths and disability-adjusted life years due to typhoid fever. Typhoid is closely linked to poverty; the highest clinical incidence occurs in poorer communities with limited access to clean water, uncontaminated food and hygienic environments.

Based on the national poverty line, Bangladesh’s poverty rate was 18.7% in 2022, according to the World Bank. Data shows that this rate has risen in recent years, with estimates projecting an increase to 21.2% in 2025. Factors contributing to this include weak labor markets, high inflation and depressed wages. Children face a disproportionately high impact. Studies in Dhaka have shown that children under 15 are at an abnormally high risk for typhoid, with elevated clinical incidence rates. This has driven the government of Bangladesh to prioritize child-focused prevention efforts.

Antibiotic Resistance: A Growing Barrier

One major factor complicating typhoid control initiatives is antibiotic resistance. S. typhi continually evolves, developing resistance to medications that were once highly effective. As of 2022, the newest strain—extensively drug-resistant (XDR) typhoid—could resist both first- and second-line treatments. Few medications remain effective, posing significant challenges for countries with limited health care infrastructure, fewer resources and higher poverty rates.

To address this, the government of Bangladesh proposed introducing typhoid conjugate vaccines (TCVs) to prevent typhoid among children. Compared to live vaccines, TCVs offer increased efficacy, stronger immune responses and the ability to be administered to children as young as 6 months. A 2024 study assessing cost-saving strategies for vaccine administration found that any rollout strategy would be cost-saving compared to current conditions.

The 2025 Nationwide Campaign

In October 2025, Bangladesh launched a nationwide vaccination campaign to protect children from drug-resistant typhoid. The monthlong campaign aims to vaccinate 50 million children between the ages of 9 months and 15 years with one dose of a TCV. The vaccine offers five years of protection, helping slow transmission among children.

The campaign specifically targets low-income areas such as urban slums and poorly connected rural regions due to the elevated clinical incidence and associated risks in these settings. Once the campaign ends, the TCV will be integrated into the national vaccination schedule in 2026 for children under 1, ensuring continued protection.

The campaign, supported by Gavi, the Vaccine Alliance, United Nations International Children’s Emergency Fund (UNICEF) and the World Health Organization (WHO), has already led to the vaccination of 38 million children across Bangladesh, despite interruptions caused by misinformation and vaccine hesitancy. As the campaign approaches its end date, some field officers and parents have voiced interest in extending vaccination deadlines to ensure broader coverage.

Looking Ahead

Overall, this vaccination campaign is a significant step toward the eradication of typhoid in Bangladesh and improving the standard of living for not only children but for the nation at large.

– Nikhil N Kumar

Nikhil is based in Lexington, MA, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr