[🇧🇩] Healthcare Industry in Bangladesh

[Saif]

SWAp’s effectiveness for Bangladesh’s health sector

Exploring alternatives to SWAp in Bangladesh’s health sector is a pressing discussion.

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SWAp’s effectiveness for Bangladesh’s health sector

There is an urgent need for a comprehensive overhaul of Bangladesh’s health system. PHOTO: ORCHID CHAKMA

UHC Forum is a coalition of health sector practitioners, advocates and academics dedicated to a strategic push on the universal health coverage (UHC) agenda. UHC Forum Health Debates is one of its flagship activities carried out in partnership with the Power and Participation Research Centre (PPRC). This op-ed is derived from the health debate on the Sector Wide Approach (SWAp) modality adopted for health sector planning and implementation since 1998.

The Sector-Wide Approach (SWAp), introduced in Bangladesh in the late 1990s, sought to improve the health sector by uniting the efforts of government, donors, and NGOs under a unified national plan. The strategy proved effective in several areas—enhancing coordination, reducing duplication and ensuring more efficient use of resources. It fostered a government-led approach, empowering the Ministry of Health and Family Welfare (MOHFW) to take ownership of health programmes and make decisions that align with national priorities. The pooling of funds from various donors simplified financial management and allowed for a more harmonised implementation of health services. Moreover, SWAp contributed to capacity building by strengthening institutional frameworks, enhancing local expertise, and promoting evidence-based policymaking. However, SWAp also faced substantial challenges. Key stakeholders, such as the private sector and the Ministry of Local Government, Rural Development and Co-operatives, were excluded from planning processes, limiting its scope and effectiveness. Centralised decision-making created bureaucratic delays, slowing programme implementation. Additionally, larger donors, such as the World Bank, exerted disproportionate influence, at times, prioritising global agendas over local needs. The risk of mismanagement also grew as pooled funding lacked adequate oversight and accountability mechanisms.

To address these shortcomings, I advocate transitioning to a new model, termed Sector-Wide Inclusive Planning and Evaluation (SWIPE) to integrate private sector actors, and decentralised planning and budgeting to the district level.-----Dr Abu Jamil Faisel is a public health expert.

There is an urgent need for a comprehensive overhaul of Bangladesh's health system. The existing dual-budget structure, which separates operating and development budgets, lacks coherence and prevents effective symbiosis between routine operational costs (staff salaries, fuel and utilities, repair and maintenance, travel, etc), and development costs for new infrastructure development and health service improvements.

The Health Population and Nutrition Sector Program (HPNSP) under SWAp brought advantages such as faster decision-making, delegation of authority to health managers, health workforce capacity building, improved coordination, monitoring and supervision. However, critical issues remain unresolved. Universal health coverage, elimination of healthcare discrimination, substantial improvements in healthcare quality, avoidance of verticalisation in healthcare delivery, and the reduction of out-of-pocket expenses continue to elude the system.

The fragmented and verticalised delivery of healthcare services limits integration and patient-centred care. Bangladesh's age-old health systems have many inherent defects. The HPNSP or any similar prescription will not remedy it. Bangladesh urgently needs a serious and massive overhaul of its health systems in overall structure and processes to enable it effectively meeting the population's health needs through integrated primary healthcare, sustainable universal health coverage, health sustainable development goals (SDGs), and client satisfaction.----Professor Dr Abul Kalam Azad is former director general of health services.

Exploring alternatives to SWAp in Bangladesh's health sector is a pressing discussion, given the challenges faced in achieving sustainable programme outcomes. One of the critical considerations is whether it is time to pivot back to the original revenue-based system or implement a hybrid model that leverages the strengths of both approaches. The revenue-based system, rooted in direct budget allocations, could potentially offer more flexibility and control for domestic health programme funding. Ensuring financial sustainability remains a key focus as stakeholders debate these alternatives. The path forward must address how Bangladesh can maintain or enhance programme effectiveness without depending heavily on SWAp, which, while comprehensive, often leads to dependency on external funding and complex coordination issues.

A well-articulated roadmap is essential for transitioning from SWAp to a new or modified system that prioritises local ownership and resilience. The government must lead with robust policy frameworks, while development partners can assist with technical expertise, transitional funding and access to global best practices.
-----Dr Md Aminul Hasan is a health system expert.

SWAp has played a pivotal role in shaping Bangladesh's health sector, improving coordination, ownership, and resource management. However, its limitations, including rigidity, donor dependency, and exclusion of key stakeholders, necessitate a reimagined approach.

Hybrid models, public-private partnerships, national health insurance schemes, and decentralised planning offer pathways to address these challenges. As Bangladesh works toward achieving universal health coverage and the health-related Sustainable Development Goals by 2030, a collaborative, inclusive, and forward-looking strategy will be essential.

Health system reform requires technical solutions, strong political will, and a commitment to equity and sustainability. While reform is essential, political will and strategic intent are critical in driving meaningful health sector reform. Bangladesh's health system requires a clear focus on necessary and actionable reforms. The challenge lies in crafting precise recommendations and mobilising the political leadership needed to implement them effectively. Without sharp, actionable strategies, opportunities for impactful reform may be missed. It is essential to foster collaborative efforts across stakeholders to address systemic gaps and meet the health aspirations of the population.-----Hossain Zillur Rahman is executive chairman of Power and Participation Research Centre (PPRC) and convener of universal health coverage (UHC) Forum.​

 

[Saif]

Three examples of badly-run public hospitals

Prioritise recruitment and efficient management

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Three examples of badly-run public hospitals
Prioritise recruitment and efficient management

We are appalled by the findings of a report by The Daily Star on three hospitals run by the Dhaka South City Corporation (DSCC), highlighting an acute shortage of staff and underutilised facilities, which cause unnecessary suffering for patients. In a city where accessible healthcare is increasingly out of reach for ordinary citizens, it is unacceptable that these public hospitals offer substandard services. This is a direct result of neglect and apathy from the Directorate General of Health Services (DGHS) and the Ministry of Health, a situation that has worsened over decades.

These hospitals are vital for low-income and lower-middle-class communities, as they offer subsidised healthcare. However, patients are forced to wait for hours due to the severe shortage of doctors, nurses, and other essential staff. As patient numbers rise, one hospital operates with half the required manpower. For instance, Mohanagar General Hospital, which installed ICU units and high-flow oxygen equipment during the Covid pandemic, cannot use them because there are no trained personnel. The surgery department has been non-functional since 2015, and high-dependency unit (HDU) beds installed in 2021 remain unused. Many posts are vacant, further crippling the hospital's ability to function.

A similar manpower crisis exists at Dhaka Metropolitan Children's Hospital, where the paediatric surgery department has been inactive since 2012, and 40 of the 100 beds remain unused. Nazirabazar Matri Sadan is also grappling with a shortage of doctors and essential medicines.

In all three hospitals, staff are spread too thin, leaving patients without the necessary medical care. Despite repeated official letters sent to the health ministry and DGHS, no action has been taken. These hospitals reflect the dysfunction plaguing public healthcare across the country, with severe staff shortages making them nearly non-functional. The DGHS and health ministry have ignored the needs of these hospitals for years. Why has this been allowed to continue? What happened to the allocated budgets? If they were insufficient, why wasn't more funding provided?

The healthcare system, especially in public hospitals, continues to be marked by gross inadequacies. And the conditions at these hospitals are a perfect example of that. We urge the interim government to immediately investigate these issues and take corrective action. The recruitment of medical personnel should be a top priority, along with the training of staff to operate specialised equipment. Meanwhile, strict management oversight is necessary to ensure that no resources go underutilised. Access to healthcare is a basic right, and the government must restore functionality to these hospitals as soon as possible.​

 

[Saif]

A wake-up call for Bangladesh to reform its healthcare

India’s visa restrictions on Bangladeshi nationals, while initially perceived as a barrier, could serve as a wake-up call for Bangladesh to strengthen its healthcare system and regain the confidence of its patients.

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A wake-up call for Bangladesh to reform its healthcare

India's visa restrictions on Bangladeshi nationals, while initially perceived as a barrier, could serve as a wake-up call for Bangladesh to strengthen its healthcare system and regain the confidence of its patients. With as many as 3.5 lakh Bangladeshis seeking medical treatment in India annually, the restrictions offer a unique chance for local providers to address systemic issues and retain patients who would otherwise travel abroad. Experts urge Bangladesh's health authorities to rise to the occasion and rebuild trust among its citizens.

This systemic overhaul is especially urgent given the personal struggles of individuals like Sanjida (not a real name), a Mirpur resident, who faced a critical health challenge in 2020. After undergoing surgery at Dhaka's Green Life Hospital to remove an ovarian cyst, her biopsy reports delivered devastating news: she had cancer. Advised to start chemotherapy, she followed her oncologist's recommendation for additional tests, only to realise that the tests she had completed earlier had been overlooked. It became apparent that her doctor's approach was perfunctory at best. Terrified and disillusioned, her family decided to seek treatment abroad.

Sanjida travelled to Mumbai's Tata Memorial Hospital, where doctors reviewed her medical history and conducted fresh diagnostics. They concluded that the surgery in Dhaka had been incorrect. With an appropriate operation, her cancer could have been addressed earlier. After another surgery and three rounds of chemotherapy in Mumbai, she returned to Dhaka. Today, she takes regular medication and visits India every six months for follow-ups. Reflecting on her ordeal, Sanjida laments the inattentiveness and unprofessionalism she experienced in Bangladesh's medical system, contrasting it with the care she received in India.

"Even with the high cost of living and transportation, Indian hospitals are more affordable and trustworthy than those in Dhaka," she said.

Sanjida's story is not unique. Retired government officer Shahidur Rahman, 69, sought cardiac care in 2019 after experiencing chest pain. Diagnosed with three heart blockages at two leading hospitals in Dhaka, he was advised to undergo stent placement. Sceptical, Shahidur travelled to Bengaluru to consult Dr Devi Shetty, a renowned cardiologist. Additional tests revealed no blockages, and he was prescribed medication instead. Since then, Shahidur has lived without chest pain and has lost faith in Bangladeshi healthcare providers.

A CRISIS OF CONFIDENCE

The healthcare industry in Bangladesh is dominated by the private sector, which has seen significant growth in tertiary hospitals and diagnostic centres.

The stories of Sanjida and Shahidur are emblematic of a deeper issue -- a healthcare system grappling with a crisis of trust. On the surface, Bangladesh's healthcare infrastructure appears robust. The country boasts 566 public hospitals, which include 37 state-run medical colleges providing hospital services, and around 5,000 private medical facilities. Private sector investment has led to the growth of tertiary hospitals and diagnostic centres, creating an illusion of progress. Yet, beneath the numbers lies a stark reality: many Bangladeshis still feel compelled to seek treatment abroad, believing that local facilities cannot meet their needs.

The reasons for this exodus are manifold. Experts point to rushed consultations, diagnostic errors, steep treatment costs, and a perceived indifference from medical professionals. Many patients complain of being treated like mere numbers -- hurried through appointments with little to no time for questions, clarification, or reassurance. This lack of a personal touch often proves just as alienating as the more tangible deficiencies. In contrast, some patients argue, India has built a reputation for offering not only medical expertise but also a level of care that feels holistic and humane.

Bangladeshi patients primarily travel to India for cardiology (14 percent), oncology (13 percent), gastroenterology (11 percent) and other complex issues, according to a 2023 study published by the National Library of Medicine. The same report found that India's healthcare infrastructure -- including skilled specialists and comprehensive follow-up care -- attracts an estimated 3 lakh to 3.5 lakh Bangladeshi patients annually. Kolkata, Chennai, Vellore, and Mumbai are the most frequented destinations.

"Bangladesh's healthcare system lacks sufficient skilled physicians and technologists, especially for complex diseases like cancer and organ transplants," said Rumana Huque, a health economist and professor at Dhaka University. "While we have capable doctors, they are overstretched and unable to provide the level of care patients expect."

Bangladeshis spend over $5 billion annually on medical treatment abroad, with India and Thailand as top destinations. Yet, Huque emphasised, many of these expenses could be curtailed if local healthcare providers improved their practices.

Tamzeed Ahmed, a clinical and interventional cardiology specialist at Evercare Hospitals Dhaka, observed that the past two to three months have seen an uptick in patients seeking consultations in India. This trend persists despite India's visa restrictions.

Meanwhile, Md Esam Ebne Yousuf Siddique, chief operating officer of Square Hospitals, highlighted the uncertainty surrounding the long-term impact of these restrictions. He noted that, over the last three years, Square Hospitals has not recorded any significant fluctuation in patient numbers, suggesting that the effects of visa restrictions on local healthcare utilisation may still be unfolding.

SYSTEMIC CHALLENGES AND PATIENT DISSATISFACTION

Patients often cite Bangladesh's under-resourced diagnostic facilities and dismissive medical culture as significant deterrents. Even private hospitals equipped with advanced technology struggle due to a lack of trained personnel to operate it effectively.

Syed Abdul Hamid, a professor at the Institute of Health Economics, Dhaka University, pointed out that poor diagnostic accuracy, inadequate consultation time, and indifferent behaviour from medical professionals erode trust. "Doctors in India excel in patient communication, providing detailed explanations and emotional support. This starkly contrasts with the rushed consultations typical in Bangladesh," he said.

During the Covid-19 pandemic, when international travel was restricted, Bangladeshi patients had no choice but to rely on local healthcare providers. Many received quality care, proving that the country's medical system can deliver when adequately supported. However, the lasting perception of neglect and inefficiency continues to push patients abroad.

CALLS FOR REFORM

Industry leaders acknowledge the gaps. AM Shamim, founder of Labaid Hospital, admitted that while Bangladeshi doctors are technically skilled, they must improve their bedside manner and spend more time with patients. "We have the capacity to treat complex illnesses, but patient trust is eroded by behaviour and insufficient consultation time," he said.

Similarly, Prof Md Moazzem Hossain of Aichi Medical Group called for systemic reform. "We need skilled technologists, uniform cost structures, and better regulation from the Directorate General of Health Services," he said. "Patients need to feel confident in their care, and hospitals must prioritise patient-centred service over immediate profits."

India's visa restrictions, while inconvenient, offer Bangladesh a rare opportunity to reflect and reform. It's a chance to rebuild confidence, invest in patient-centred care, and address the systemic flaws that push patients abroad. Without addressing these issues, experts warn, the country risks perpetuating a reliance on foreign medical services -- a dependency both costly and avoidable.​

 

[Saif]

Looking back 2024: Corruption, poor service keep hurting health sector

Quality healthcare for people remained elusive throughout 2024 while the sector saw massive allegations of corruption and maltreatment in the first half of the year.

www.newagebd.net

Looking back 2024: Corruption, poor service keep hurting health sector
Rashad Ahamad 05 January, 2025, 00:19

Quality healthcare for people remained elusive throughout 2024 while the sector saw massive allegations of corruption and maltreatment in the first half of the year.

The second half of the past year that ended Tuesday was marked by massive demonstrations by health sector employees to press home their demands after the fall of Awami League government on August 5.

Health rights activists and patients said that no significant improvement was noticed in the health sector in the past year as people suffered to get services.

They demanded health sector’s legal reform, a pragmatic master plan, transparency, accountability and adequate budgetary allocation for the improvement of the sector.

Dhaka University’s Institute of Health Economics professor Syed Abdul Hamid said that the student-led July movement in 2024 created a huge scope for improvement, but still there was no visible impact.

He emphasised the health sector reform commission’s recommendation, legal reform, patients’ safety and service providers’ security for the development of the sector.

At the beginning of the year, a number of patients, including children, had died in alleged maltreatment that compelled the health department to conduct nationwide drives.

The Directorate General of Health Services closed on various grounds at least 1,600 hospitals and clinics in a month-long drive.

Sector people said that the healthcare institutions which were shut for different unlawful activities during the drive were back to operation again.

Runa Khatun, a resident of Sadullapur in Gaibandha, said that getting physician in a district- or upazila-level government hospital was very rare in her district while the physician was available in private medical facilities.

Janaastha Sangram Parishad convener Faizul Hakim Lala said that the ousting of a regime was a remarkable achievement in 2024 that created hope among the people for a new journey.

He urged for removing discrimination among the villagers and the city dwellers.

He also urged to ensure the presence of physicians at work stations and regular posting denying any political or other influences.

He said that the authorities must evaluate merit and qualification in posting.

He suggested decentralising the healthcare and producing adequate number of healthcare givers like doctors, nurses and technicians.

Public health campaigner Lenin Choudhury said that the DGHS was the first department which was formed after the independence of the country, but the department failed to place a comprehensive plan for the people’s health.

‘The DGHS is doing everything on an ad hoc basis,’ he said, adding that they needed a comprehensive plan and its proper implementation.

He said that a healthcare system sustained on five pillars, including promotive, curative, rehabilitative and palliative.

The government should give emphasis on the healthcare system that includes all of them, he said.

He said that the government promised to set up a 10-bed ICU facility in every district, but the service was still not available.

Rights activists said that healthcare was still expensive that the common people could afford.

They demanded reducing out-of-pocket healthcare expenditure.

The out-of-pocket healthcare expenditure in the country rose to 73 per cent in 2021 while it was 68.5 per cent in 2020, according to the Bangladesh National Health account.

Of the total out-of-pocket spending, 54.40 per cent was spent for purchasing medicines, 27.52 per cent for diagnosis, 10.31 per cent for consultation and 7.77 per cent for transport.

About 64 lakh people in the country get poorer every year due to high medical costs, according to a 2010 research by the icddr,b.

The government failed to control the prices of lifesaving drugs as the manufacturers have been increasing the drug prices at will over the years, rights activists said.

They said that the government had also a little control on the prices of medical equipment.​

 

[Saif]

Campaigners seek free healthcare

The Health Sector Reform Commission in 50 days of its formation is still gathering information and opinions on several focal areas such as service improvement while public health campaigners and medical practitioners demand free healthcare at all public health facilities...

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Campaigners seek free healthcare
Sadiqur Rahman 09 January, 2025, 00:28

The Health Sector Reform Commission in 50 days of its formation is still gathering information and opinions on several focal areas such as service improvement while public health campaigners and medical practitioners demand free healthcare at all public health facilities.

The latters expect sharper surveillance of overall health facilities, effective corruption-control measures and rational distribution of logistics between urban and rural healthcare centres.

The interim government formed the 12-member Health Sector Reform commission on November 18, 2024 for submitting necessary reform proposals in 90 days to make the country’s healthcare services people-oriented, accessible and universal.

Commission member Muzaherul Huq, also a former senior adviser to the World Federation for Medical Education, recently told New Age that the commission identified several focal areas for reforms.

‘We are gathering information and opinions from related professionals at grassroots-level and urban healthcare centres where marginalised people often visit for medical treatment. Our mission is to propose necessary improvements of the facilities so that patients can access better healthcare,’ Muzaherul said.

The commission has been analysing the autonomy of upazila health complexes, at least for procuring crucial logistics, and strong monitoring over its expenditures, he said.

The commission has also been talking to teachers and students at institutions of public health, medical science and nursing training, and paramedics and technicians to gather suggestions on the improvement of the health and medical science education, he said.

‘Improving the facilities for continuing education or professional training would be another focal area,’ said the commission member, adding, ‘widening scopes for research on the related fields would be focused.’

About corruption in the health sector, Muzaherul said that the issue had already been identified by several local and international organisations.

He said, ‘We will definitely recommend necessary measures to check corruption. At the same time, we will recommend conflict management procedures to minimise patients’ grievances and safety for the health practitioners as well.’

Public health campaigners have, however, demanded that the commission must recommend completely free medical facilities, including diagnosis and supply of medicines, at all public hospitals.

Faizul Hakim, the convener of the Janaswastha Sangram Parishad, a platform for raising voices against irregularities in the public health sector, said, ‘The government must bear the people’s health expenditures. I won’t recommend health insurance to facilitate insurance businesses.’

Non-practicing allowance for the physicians at public hospitals, limiting fees at physicians’ private chambers, strict surveillance over the services and expenses at the private hospitals and diagnosis centres, and a functional and independent Bangladesh Medical and Dental Council are among Faizul’s recommendations.

‘Corruption has paralysed the health sector, cornering the patients and their distressed families. Recommendations should come to check corruption anyhow,’ Faizul demanded, adding that the commission must come up with a white paper investigating the alleged corruption during and after the Covid pandemic.

‘Irregularities in procuring corona vaccines must be investigated.’

Public health and preventive medicine specialist Lenin Chowdhury said that reform proposals must include a comprehensive healthcare plan combining public health and treatment, defining rights and responsibilities of private clinics and practitioners, monitoring the quality of medical colleges and training institutions, a short-mid-long-term road map for manpower recruitment in the health sector and experts-led health ministry.

‘The insolvent patients need a safety net. Moreover, there must be a guideline for bringing poverty-ridden patients under a universal healthcare system,’ Lenin said.

Commission chief Professor AK Azad Khan, also the president of Bangladesh Diabetic Society, said that the commission continued discussing with key stakeholders, including common citizens.

‘We would prepare a precise draft of reform proposals at the end of this month,’ Azad said.​

 

[Saif]

A public cancer hospital in crisis

Prolonged equipment failure at NICRH is unacceptable

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A public cancer hospital in crisis
Prolonged equipment failure at NICRH is unacceptable

VISUAL: STAR

It is deeply concerning that the National Institute of Cancer Research and Hospital (NICRH)—the country's premier public facility for cancer care—is failing to provide radiotherapy treatment due to prolonged equipment failure. For over 19 days, according to a report by The Daily Star, all six radiotherapy machines at the hospital have been out of service, forcing cancer patients to delay their treatment at the risk of their conditions worsening or spreading.

NICRH is not just another healthcare facility; it is a lifeline for many patients, especially those from poor backgrounds, who rely on its subsidised services. For such a vital institution to go even a single day without functioning radiotherapy machines is thus unacceptable. That the current paralysis has dragged on for nearly three weeks only shows the gravity of the situation. In fact, the equipment failure has been a persistent problem for NICRH: one of the machines has been out of order for two years, and another for over a year. How has such a critical problem been allowed to continue unchecked for so long?

For many cancer patients, seeking treatment at private clinics is not an option due to the exorbitant costs involved. They rely on NICRH for affordable care. When that care is delayed, they face harrowing choices—some borrow or exhaust their life savings to seek private treatment, while others are left with no option but to wait, risking their lives as cancer progresses.

Reports of similar incidents paint a grim picture of recurring dysfunction at NICRH. Last year, Prothom Alo reported that all of the hospital's radiotherapy machines had malfunctioned. At that time, even the X-ray machine was out of order for two weeks. These repeated breakdowns are symptomatic of a broader systemic failure in public healthcare, at the core of which lies a disturbing culture of indifference and irregularities. Instead of prioritising urgent repairs or replacing outdated equipment, hospital authorities have shown a complacent attitude, waiting for external interventions that rarely come in time.

For many cancer patients, seeking treatment at private clinics is not an option due to the exorbitant costs involved. They rely on NICRH for affordable care. When that care is delayed, they face harrowing choices—some borrow or exhaust their life savings to seek private treatment, while others are left with no option but to wait, risking their lives as cancer progresses.

We urge the health authorities to address this crisis immediately. The radiotherapy machines at NICRH must be repaired or replaced immediately, and measures must be taken to prevent such prolonged disruptions in the future. The possibility that certain vested quarters may be deliberately sabotaging these machines to drive patients towards private facilities must also be thoroughly investigated. The health directorate's long-standing failure to properly oversee public hospitals like NICRH also must be rectified.​

 

[Saif]

Healthcare system needs a thorough shakeup

That the country's healthcare system is plagued by a lot of discrepancies and inadequacies does not require any elaboration. Volumes have been said and written on this particular issue over the years but to no avail. Speakers at a debate programme organised in the city late last week came up

thefinancialexpress.com.bd

Healthcare system needs a thorough shakeup
Published :
Feb 08, 2025 22:34
Updated :
Feb 08, 2025 22:34

That the country's healthcare system is plagued by a lot of discrepancies and inadequacies does not require any elaboration. Volumes have been said and written on this particular issue over the years but to no avail. Speakers at a debate programme organised in the city late last week came up with a wide range of suggestions and recommendations including establishment of a regulatory body for streamlining the healthcare sector. The debate programme coincided with the government initiative to reform the sector. It may be mentioned that the interim government last November formed a Health Affairs Reform Commission to recommend reforms with the objective of making health services more accessible and universal. The core recommendation of the programme was the establishment of a regulatory body to standardise pricing, enforce quality accreditation and form a grievance mechanism for the patients.

Though there are several health-related agencies under the Ministry of Health and Family Welfare, those have hardly any control over cost of treatment, especially in private hospitals and clinics. These private healthcare outlets fix treatment charges whimsically. They do not bother to take into consideration the paying capacity of the poor and low-income people. In view of this, the speakers at the debate programme underscored the need for enacting a comprehensive health law and creating a central regulatory authority to oversee private sector engagement in health services. Patients usually do not have the scope to know beforehand how much they will have to spend for a specific treatment. For lack of effective control, pharmaceutical companies arbitrarily fix prices of medicines and increase them quite frequently. These are some of the reasons why expense for treatment is so high in Bangladesh. It is because the treatment cost remains much beyond commoners' affordability. The speakers at the programme raised concern over the high financial burden on the patients. The proposed regulatory body may devise mechanism for price control by distinguishing between actual medical cost and that charged by many healthcare outlets out of unethical commercial motive.

Healthcare services in Bangladesh are much below international standard. People do not have that much faith in the country's healthcare system. This loss of confidence prompts thousands of patients to opt for treatment outside the country at the expense of hard-earned foreign currencies from the state exchequer. Enforcement of quality accreditation is also vitally important for ensuring service quality of hospitals, laboratories and doctors. Establishment of a grievance mechanism for patients until now was an alien idea in the country. Very often patients are subjected to various forms of harassment but the victims have nowhere to go to lodge complaints for redress. The proposed grievance mechanism is expected to be a relief for the health service seekers. Similarly, public-private partnership in healthcare service is a unique idea in Bangladesh. So, serious efforts should be made to translate that idea into reality.

The Health Affairs Reform Commission has its own recommendations for streamlining the country's healthcare system. The authorities concerned are also expected to incorporate experts' suggestions if those are not already covered by the Reform Commission. Such an integration of suggestions and recommendations will hopefully free the archaic medical service system and make it accessible to common people.​

 

[Bilal9]

Bangladeshis spend $4b annually for healthcare abroad

DCCI Senior Vice President Malik Talha Ismail Bari says in a seminar on outbound healthcare tourism

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Bangladeshis spend $4b annually for healthcare abroad
DCCI Senior Vice President Malik Talha Ismail Bari says in a seminar on outbound healthcare tourism

View attachment 10882

Bangladeshis spend around $4 billion abroad every year for healthcare, according to Malik Talha Ismail Bari, senior vice president of the Dhaka Chamber of Commerce and Industry (DCCI).

This is due to a lack of specialised treatment, trust on doctors and advanced technology within the country alongside costs being comparatively lower abroad, he said.

Bari, also a director of United Hospital, was delivering a keynote paper through a presentation at a seminar, styled "Reversing the Outbound Healthcare Tourism", at the DCCI today.

There are 5,461 private hospitals and clinics in Bangladesh, of which 1,810 are within Dhaka division, he said.

People in rural areas are deprived of quality and adequate healthcare services while pressure is created for an influx of patients at healthcare facilities in Dhaka.

Limited infrastructure, a lack of skilled workforce, quality and safety concerns, low doctor-patient ratio and long waiting periods are some of the bottlenecks to access advanced healthcare in Bangladesh, he added.

Bari informed that Bangladesh allocated Tk 30,125 crore, or 3.78 percent of its national budget, for public healthcare in fiscal year 2024-25.

Pre-capita health expenditure, or annual government spending for healthcare per person, is $110 in Bangladesh whereas $401 in South Asia, he said.

Patients sometimes go abroad for healthcare services due to a lack of facilities, trust and comfort and reversing this trend requires formulation of a proper plan and identifying the bottlenecks, said National Professor AK Azad Khan.

"Since medical science is an ever-changing process, we need to have a proper curriculum to adopt the best technological advancements," said Khan, also president of the Diabetic Association of Bangladesh.

He also stressed on the standardisation of laboratories, adequate budgetary allocation, facilitating more research and strengthening the Bangladesh Medical and Dental Council (BM&DC), which is the regulatory authority for medical and dental education in Bangladesh.

Trust is a crucial factor when considering this sector's development, said Rezaul Karim Kazal, professor of the obstetrics and gynaecology department at Bangabandhu Sheikh Mujib Medical University.

Quality hospitals should be established in rural areas for wider coverage alongside customised services for all types of patients, he added.

Only doctors should be appointed through Bangladesh Civil Service for the public health administration to be run efficiently, said Syed Abdul Hamid, professor at the Institute of Health Economics of the University of Dhaka.

Moreover, a "health service commission" should be formed similar to the Bangladesh Judicial Service Commission, which assess the suitability of persons for entry-level appointments as assistant judges or judicial magistrates, he added.

Liaquat Hossain, registrar of the BM&DC, suggested that the national policy for registering foreign doctors to practice in Bangladesh could be simplified.

Of the 1,34,000 doctors in Bangladesh, only 33,000 are in public service, said Abul Bashar Md Jamal, a former professor of surgery at Dhaka Medical College Hospital.

However, over 10,000 foreign students are studying in different public and private medical colleges here, he added.

Members of middle-income households are increasingly seeking healthcare services abroad, mainly for a lack of confidence and satisfaction, said DCCI President Ashraf Ahmed.

Only a few types of advanced treatments, such as robotic surgery, are available locally, he said.

The trend can be reversed by outperforming regional competition, ensuring customer satisfaction and enhancing quality of medical services, reliability and branding initiatives, he added.

"We need to be more open to foreign doctors, nurses, medical technologists and other specialists," opined Ahmed.​

What needs to happen is for these talking heads stopping to "talk shop" and actually put in a "prescription" for concrete steps ( pun intended).

With mandatory temporary subsidies to set up specialized hospitals if necessary.

BS has gone on long enough while incompetent govt. idiots twiddle their thumbs with all these medical dollars go outside of the country.

If India can set up these substandard hospitals in Kolkata and Chennai area, there is no reason we cannot.

Also - we should set up some kind of necessary re-certification every year to train and certify doctors.

We need guarantees that our doctors are trained beyond a certain standard and fake doctors are weeded out.

 

[Saif]

What needs to happen is for these talking heads stopping to "talk shop" and actually put in a "prescription" for concrete steps ( pun intended).

With mandatory temporary subsidies to set up specialized hospitals if necessary.

BS has gone on long enough while incompetent govt. idiots twiddle their thumbs with all these medical dollars go outside of the country.

If India can set up these substandard hospitals in Kolkata and Chennai area, there is no reason we cannot.

Also - we should set up some kind of necessary re-certification every year to train and certify doctors.

We need guarantees that our doctors are trained beyond a certain standard and fake doctors are weeded out.

Our doctors are busy with their private practice and hardly have enough time to take care of their patients. The picture of all the public hospitals are the same.

 

[Bilal9]

Our doctors are busy with their private practice and hardly have enough time to take care of their patients. The picture of all the public hospitals are the same.

Agreed. Doctors are licensed. Govt. has the power to revoke those licenses.

So - if doctors do not abide by the rules (like take care of their patients in public hospitals per agreed rules), govt. has to revoke their licenses. This is exactly what they do in India. Why can't we?

Govt. has to realize that the money they spent to train doctors must have a proper return.

Becoming a doctor should not be a guarantee to print money - like it is now.

 

[Saif]

Universal health coverage: a reality or mirage?

The aspiration for universal health coverage (UHC), where everyone can access the necessary healthcare without facing financial hardship, remains a distant dream due to the excessive commercialisation of the health sector and a disproportionately high out-of-pocket healthcare expenditure. The UHC e

thefinancialexpress.com.bd

Universal health coverage: a reality or mirage?
Published :
Feb 16, 2025 23:00
Updated :
Feb 16, 2025 23:00

The aspiration for universal health coverage (UHC), where everyone can access the necessary healthcare without facing financial hardship, remains a distant dream due to the excessive commercialisation of the health sector and a disproportionately high out-of-pocket healthcare expenditure. The UHC envisions both comprehensive service coverage for the entire population and financial protection against the high costs of medical care. While Bangladesh has made significant progress in expanding healthcare facilities, financial protection remains a major challenge. According to a World Bank study, over 73 per cent of total health expenditures in Bangladesh are borne directly by households, one of the highest in the world. This extremely high out-of-pocket spending has severe consequences. According to a study by the Bangladesh Institute of Development Studies (BIDS) soaring out-of-pocket healthcare expenses pushed 61 lakh Bangladeshis, or 3.7 per cent of the population, into poverty in 2022. Experts in a recent view exchange meeting have called for implementing a robust regulatory framework, ethical pricing mechanisms, and stronger supply chains to address the issue.

For Bangladesh to progress on the financial protection agenda, two key actions are necessary. Firstly, a significant increase in the health budget is essential. The World Health Organization suggests allocating at least 15 per cent of the total budget to the health sector, but Bangladesh allocates only around 5.0 per cent. The country's health budgetary support is one of the lowest in the South-East Asia region. The less a government spends on health, the higher out-of-pocket payment is sure to be. So, increased budgetary allocation is indispensable, particularly for ensuring access to healthcare for the poor, vulnerable, young, old, and informal workers - in essence, the majority of the population.

Secondly, the government must ensure optimum utilisation of the health budget by increasing allocation for government hospitals, health centres and healthcare professionals. However, increased allocation will not translate into enhanced facilities if corruption and some other irregularities in the health sector are not properly addressed. Absenteeism of doctors in government hospitals, particularly in rural areas has been an endemic problem. Many doctors exhaust their time and energy attending private clinics which leaves them with hardly any time for government hospitals where they are appointed to serve. It is the poor patients who mostly seek treatment at government hospitals and bear the brunt of these irregularities. Moreover, facilities in these hospitals like free medicines are scarce and those that exist do not come to the benefit of the poor due to mechanisms of vested quarters. So, to protect the poor from skyrocketing healthcare costs, public healthcare facilities must be better equipped with the necessary resources and logistics, and healthcare providers must be held accountable.

The country's high out-of-pocket healthcare expenses are not only pushing more people into the vicious cycle of poverty but also widening the gap between the rich and the poor. Globally, countries with robust government healthcare systems have achieved more equitable growth. For Bangladesh, allocating more resources to the health sector and implementing a strong strategy for enhancing financial protection for the poor and vulnerable will be crucial in ensuring access to basic healthcare for all. Otherwise, the vision of achieving universal health coverage will remain a mirage, not a reality.​

 

[Saif]

Hospitals need proper waste disposal

Medical waste problem at Rangpur Medical College Hospital is concerning.

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Hospitals need proper waste disposal
Resolve the crisis at Rangpur Medical College Hospital

VISUAL: STAR

We are concerned about the medical waste problem at Rangpur Medical College Hospital where hazardous waste has been piling up inside the premises, posing health risks to both patients and visitors. According to a report by this daily, the planned construction of a waste management plant at the hospital has remained suspended for over five months due to protests from locals.

Locals are apparently worried that the plant's location, near the district's Bangladesh Medical Association building and adjacent residential areas, would cause odour pollution and pose health risks. They also allege that the plant does not have a location clearance certificate from the Department of Environment. Meanwhile, approximately 1.5 tonnes of waste, including 300 kilogrammes of hazardous waste generated daily by the hospital, are not being disposed of properly, which can have serious consequences.

Unfortunately, the situation at Rangpur Medical College Hospital is not an isolated one. Around 83 percent of hospitals in our country do not have a waste management system, according to a 2022 study by the Transparency International Bangladesh (TIB). The study also found that around 60 percent of hospitals do not have bins to store medical waste, let alone ensure basic segregation among reusable, recyclable, and non-recyclable waste—with hazardous medical waste being mixed with solid garbage in the bins that are available. In fact, at the Rangpur hospital, such waste is currently being dumped out in the open. Do the locals opposing the waste management plant not see the health risks of this uncontrolled dumping? A properly constructed waste management plant cannot pose more risks than the current situation.

Under these circumstances, hospital authorities must engage with locals, raise awareness with the help of experts if necessary, and ensure the plant's construction follows all due process. Meanwhile, all public hospitals in the country must take urgent action in line with the recommendations that came up in the TIB study. Simultaneously, the government must enforce the Medical Waste Management and Processing Rules 2008, penalising any non-compliance. The authorities also must ensure proper hygiene and cleanliness in public hospitals so that people do not fall sicker while undergoing treatment because of hospital-acquired infections.​

 

[Saif]

What would the healthcare sector of the future look like?

Healthcare around the world is going through unique and dynamic changes.

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What would the healthcare sector of the future look like?

Photo: REUTERS

Healthcare around the world is going through unique and dynamic changes. Global megatrends like climate change, technological advancements, demographic shifts, and social changes are all impacting the stakeholders in healthcare—patients, practitioners and businesses—in significant ways. According to one estimate, the world population is likely to reach nine billion in another decade, with Bangladesh's population likely reaching 190 million. As a result, providing affordable healthcare services for such a large population will create both challenges and opportunities.

While there has been significant progress in reducing the incidence of malaria, tuberculosis (TB) and diarrhoeal diseases, ailments associated with the modern lifestyle, such as obesity, are rising exponentially. The risk of ailments caused due to environmental threats and natural disasters is also likely to rise in the coming years. At the same time, newer drug discoveries are making the cure of many diseases possible, and in certain instances, more affordable.

All these factors are forcing the healthcare delivery ecosystem to undergo a transformation that will be relevant for the future, while keeping patients and consumers at the centre. The entire care delivery ecosystem will be attributed by the capabilities of the ecosystem participants of being preventive, personalised, predictive, and by their points of healthcare delivery.

With the increasing focus on disease risk factors and self-directed healthier way of living, the need for curing many diseases associated with the lifestyle will decrease with time. A considerable number of businesses are likely to grow and lead this domain by delivering such services. On the one side, there will be providers of basic consultations on lifestyle, diet and physical exercise. On the other, there will be diagnostic service providers who would help in measuring the key health parameters to detect early indicators of life-threatening diseases or clinical incidents.

While such preventive care has significant impact in elevating the overall health of the population, it should be noted that the beneficiaries of such care are not sick individuals, but individuals who maintain a regular and good quality of life. Therefore, the patient experience—i.e. how such care gets delivered— would play a significant role in business success of the providers. Additionally, personalisation will be a key component in delivering unique patient experiences.

Personalisation of care also means bringing life sciences into the picture. Personalised medical examinations and clinical investigations result in better diagnosis of ailments and tailored prescriptions for cure. By deploying new generation biotechnology and genetic research findings, each patient's needs become unique and require unique treatment decisions. Some healthcare providers in the developed countries have already started offering such care to patients in areas like heart health, diabetic care, and metabolic activities.

In addition to biotechnology, other technological advancements, particularly in digital technologies and artificial intelligence (AI), are going to make a significant impact in the healthcare of the future. In fact, a prominent attribute is going to be predictive and proactive care for the patients. The vast amount of health data collected from a wide range of demographic populations is enabling the creation of tools that enable the prediction of many health accidents pre-emptively. Such predictive analysis can be used for the proactive treatment of the patients resulting in prevention of the same.

All of these suggestions can be implemented at a wide range of locations, including the homes of the patients. Technology has enabled care delivery points to become omnipresent with the use of telehealth services, community-based services, and remote interventions through robots. Access to healthcare has become easier with the advent of technology.

However, the inclusive access to healthcare will require a robust ecosystem of private-public partnerships to improve its reach and affordability. For private entrepreneurs, the business potential in highly populated countries like Bangladesh is enormous. At the same time, it's the collective responsibility of private-public partnerships to make such care delivery inclusive so that they are accessible to all levels of the economic pyramid.

Arijit Chakraborti is partner with PwC.​

 

[Saif]

Reimagining primary healthcare through the GP system

Despite progress in Bangladesh’s health sector, primary healthcare (PHC) remains inadequate, particularly in rural areas where access to qualified doctors is limited.

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Reimagining primary healthcare through the GP system

FILE PHOTO: AMRAN HOSSAIN

The general practitioner (GP) system is the cornerstone of healthcare in many countries, providing individuals with their first point of contact for medical care. GPs are trained medical professionals who diagnose and treat various health conditions, from minor illnesses to chronic diseases, while emphasising preventive care through regular checkups, vaccinations, and health education. Acting as gatekeepers, GPs coordinate patient care, referring them to specialists when needed. Countries that have achieved universal health coverage—such as the UK, Australia, and Canada—rely heavily on GP systems to improve accessibility, ensure continuity of care, and enhance health outcomes.

Despite progress in Bangladesh's health sector, primary healthcare (PHC) remains inadequate, particularly in rural areas where access to qualified doctors is limited. Urban areas, on the other hand, lack a structured PHC delivery system, forcing citizens to rely on hospitals and informal healthcare providers. This leads to high out-of-pocket expenses.

UHC, which envisions accessible, affordable, and quality healthcare close to home, remains an elusive goal in Bangladesh. A well-structured GP system could take us one step ahead. It could revolutionise healthcare delivery by ensuring that every individual has access to a registered family doctor. A proposed GP model for Bangladesh would assign a medical team to every 5,000 people, led by a graduate doctor. Families would register with a GP team, with the flexibility to change providers every six months. GPs would be contractually appointed, with performance-based renewals tied to measurable outcomes like healthcare provision and patient satisfaction. Vulnerable populations would receive free or subsidised services, while emergency care, including ambulance services, would be universally free.

Under the system, the existing infrastructure, such as community clinics in rural areas, could minimise implementation costs. In urban areas, rented facilities could serve as GP centres. An integrated approach linking the GP system with the broader healthcare network would be essential for success. Public-private partnerships (PPPs) are essential for bridging gaps in the country's healthcare system. While current PPPs focus primarily on construction models, there is untapped potential in service-driven contracts, such as operation and maintenance, and greyfield upgrades.

However, the integration of the GP system into government structures requires a robust payment model. Salary-based systems may fail to motivate, whereas pay-for-performance or fee-for-service models incentivise quality. Bundled payments, capitation or global budgets offer flexibility, but payment models must prioritise comprehensive care, including promotion, prevention, treatment, and rehabilitation.

PPP agreements must include clear quality indicators. The private sector is adept at maximising profit; therefore, the government must skilfully set and enforce quality standards within contracts. Transparent performance reporting and strong monitoring frameworks are essential to maintaining accountability and ensuring that healthcare providers meet their obligations. The experience of integrating PPPs in other sectors offers valuable lessons for healthcare. By aligning community clinics, government structures, and private partnerships, Bangladesh can create a more equitable, efficient, and patient-centred healthcare system.

Even so, the financial viability of a GP system poses significant challenges. Bangladesh's low tax-to-GDP ratio, lack of social insurance frameworks, and predominantly informal workforce are major barriers. Global models, such as tax-based systems in the UK and Canada, performance-linked funding in Sweden and New Zealand, and mixed approaches like Singapore's, offer valuable lessons. Emerging economies like Rwanda and Thailand demonstrate the feasibility of community-based insurance and capitation-based funding for GP systems.

For Bangladesh, direct contributory mechanisms for the informal sector are impractical in the short term. Despite these challenges, several avenues could be explored, such as: i) redirecting unutilised funds within the health sector budget; ii) imposing targeted taxes on sugary beverages, luxury goods, and tobacco; iii) leveraging corporate social responsibility (CSR) funds; and iv) introducing minimal monthly charges or per-minute phone call fees. However, university students, formal workforce groups like garment workers, and other groups like bank account holders and microcredit beneficiaries, may be brought under compulsory health insurance schemes.

Bangladesh's COVID vaccination programme which successfully registered over 13 crore individuals using national identity cards (NIDs), highlights the potential for technology-driven healthcare solutions. A nationwide health card system could centralise patient data, enabling personalised, data-driven care. Additionally, artificial intelligence (AI) and the Internet of Things (IoT) could streamline healthcare processes by enabling real-time health data tracking, efficient referrals, and better care coordination.

The feasibility of these models has already been demonstrated through initiatives like UNICEF's Aalo Clinic programme in urban areas and Palli Karma-Sahayak Foundation's (PKSF) Samridhi programme in rural areas across Bangladesh. These examples highlight the scalability of the GP system in both rural and urban settings. By leveraging existing infrastructure, integrating advanced technology, and prioritising primary care, Bangladesh can build an equitable, efficient, and future-ready healthcare system.

Integrating the GP system into Bangladesh's broader healthcare infrastructure is a critical step toward achieving UHC. While it presents challenges, health experts generally agree that it is feasible with clear aspirations and a comprehensive, well-thought-out plan. Annual performance audits, based on defined quality metrics, will identify service gaps and areas for improvement, with public reporting enhancing transparency. A well-functioning complaint redress system will also be crucial for resolving patient grievances and maintaining satisfaction. It is important to avoid shortcuts and carefully consider the ground realities to prevent the common pitfalls that often arise during implementation.

The authors are members of UHC Forum and PPRC and experts in the health sector.​

 

[Saif]

Price ceiling should be priority health reform agenda

AS THE government discusses the reform strategy for the health sector, it should take into account findings of the Bureau of Statistics survey on public health services that reflect people’s demands and expectations. The survey report...

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Price ceiling should be priority health reform agenda
22 March, 2025, 00:00

AS THE government discusses the reform strategy for the health sector, it should take into account findings of the Bureau of Statistics survey on public health services that reflect people’s demands and expectations. The survey report published on March 20 says that more than 90 per cent of the people have urged the government to contain extremely high prices of health services, including medicine, physician’s visit costs and diagnostic charges. People have asked for fixed retail prices for all health services, medicines and medical accessories. The demands are more than justified when there is barely any stability in the drug market. The Directorate General of Drug Administration sets prices of 117 essential medicines while prices of all other drugs are determined based on proposals of manufacturers. A recent market analysis shows that prices of drugs greatly vary. The Bangladesh Association of Pharmaceutical Industries tries to justify the price difference, saying that the quality of drugs is different for different companies, yet substandard drugs flood the market, risking public health. The health reform should implement a price ceiling mechanism for drugs and also put in place an effective quality control mechanism for pharmaceutical industries.

The health services reform survey also reports a dependence on the private sector and talks about an effective decentralisation of health infrastructure. In Barishal, Chattogram and Dhaka, people are mostly dependent on private health facilities. Mismanagement, corruption and inadequate number of beds and physicians often compel people to seek health care from private facilities. There is approximately one hospital bed for every 990 patients. This translates to 0.96 beds per 1,000 people, which is significantly lower than the World Health Organisation’s recommendation. In district hospitals, many emergency facilities, especially dealing with non-communicable diseases, are absent. The treatment of the chronic diseases requires more resources than what is available with upazila health complexes. In the absence of such services, those who can afford seek services from private hospitals and people in poverty are left with no option but to suffer. At the moment, to establish private hospitals, clinics or diagnostic centres, it is not mandatory to obtain a licence. The price chart for medical services has not been recently revised. It is evident that the government has created a situation in which the private sector has more control over health services and the regulatory mechanism has failed the patients.

It is promising that the interim government has set up a commission to suggest reforms for the health sector. The commission, considering the findings of the survey, should prioritise a price ceiling and quality control mechanism for pharmaceutical industries as a reform agenda.​

 

[Saif]

HEALTH SECTOR REFORM: Commission for referral, back-referral system

The health sector reform commission is set to recommend ‘effective’ referral and back-referral systems, connecting tertiary and grassroots health facilities.

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HEALTH SECTOR REFORM: Commission for referral, back-referral system
Sadiqur Rahman 29 March, 2025, 23:48

The health sector reform commission is set to recommend ‘effective’ referral and back-referral systems, connecting tertiary and grassroots health facilities.

According to the commission members, these systems would not only facilitate the full recovery of critical patients at minimised expenses but also lessen the burden on public and private hospitals in cities including Dhaka.

If the referral system functions effectively, insolvent patients from rural and remote villages could avail themselves of specialised medical care at tertiary hospitals, they said.

‘In our recommendation, there will be a referred-back system so that a patient, after receiving treatment at a tertiary hospital, can receive rehabilitation services at the health centre where he or she was initially admitted,’ said Professor M Muzaherul Huq, a member of the Health Sector Reform Commission.

He added that the patients would be issued a health card for sequential use.

On March 20, the Bangladesh Bureau of Statistics published a public opinion survey on Health Sector Reform 2025, revealing that 92.6 per cent of respondents supported the introduction of health cards for patients.

The BBS conducted the survey on 8,256 households across the country.

Explaining the planned referral and back-referral systems, another commission member, Syed Md Akram Hussain, said that patients’ out-of-pocket healthcare expenses would reduce significantly if the referral and the back-referral systems work effectively.

‘We are planning to develop a network of general health practitioners or family care physicians who will be the initial responders to patients. Without their referral, no patient, except in an emergency, would be allowed to visit a specialist or a specialised hospital,’ Akram said.

Such a restriction, however, would prevent patients from making unnecessary hospital visits and incurring avoidable diagnostic and medical care expenses.

‘Moreover, the fee of a family care physician will certainly be less than that of a specialist,’ he added.

According to Akram, the commission would propose the availability of at least two MBBS doctors as family care physicians, or one family care physician per 15,000 people, at union-level health centres.

Such family health physicians would also be available at the ward level in urban areas.

‘We are planning to transform all district-level general hospitals into tertiary hospitals,’ Akram said.

The BBS public opinion survey on health sector reform 2025 also revealed that 91.3 per cent of respondents wanted primary health care to be recognised as a constitutional right.

‘The constitution does not legally bind the state to ensure citizens’ primary health care. It should,’ said Faizul Hakim, convener of the Janaswastha Sangram Parishad, a public health advocacy platform.

On January 15, the Constitution Reform Commission, in its full report, recommended that the right to health, which requires ‘significant resources’ and ‘time to implement,’ should be implemented based on the ‘availability of resources,’ with a commitment to ‘progressive realisation.’

The World Health Organisation defines primary healthcare as a system that enables health services to support a person’s health needs, from health promotion to disease prevention, treatment, rehabilitation, and palliative care throughout their lifespan.

However, the Health Sector Reform Commission will propose legally binding the government to ensure citizens’ primary health care.

‘Additionally, the commission will recommend “basic emergency care” free of cost. The government will be bound to bear this cost even if a patient receives the service at a private hospital,’ Akram said.

The commission would also recommend the establishment of a separate service commission for health professionals, the formation of regional health services, the creation of a private hospital management board, the allocation of 10 per cent of private hospital beds for insolvent patients, and the prevention of pharmaceutical company owners from owning hospitals, among other measures.

On November 18, the interim government formed five reform commissions on health, media, local government, labour, and women’s affairs.

These five reform commissions were initially expected to submit their reports by mid-February. However, on March 27, all commissions were granted an extended deadline until April 30.​

 

[Saif]

Well-meaning health-sector reforms that call for will

A SOUND referral and back-referral system in health care potentially has several merits. It can ensure equitable access to specialised health care. It can optimise the use of resources. It can improve patient outcomes. It can also enhance coordination between levels of health care. This is...

www.newagebd.net

Well-meaning health-sector reforms that call for will
03 April, 2025, 00:00

A SOUND referral and back-referral system in health care potentially has several merits. It can ensure equitable access to specialised health care. It can optimise the use of resources. It can improve patient outcomes. It can also enhance coordination between levels of health care. This is, therefore, a welcome move that the health-sector reforms commission is set to recommend ‘an effective referral and back-referral system’ to link tertiary to primary health services. The commission’s members say that it would not only facilitate the full recovery of critical patients at minimised costs but also unburden public and private hospitals in cities. In a society where out-of-the-pocket expenditure of patients is too high and quality medical treatment is too costly, the likely move certainly appears a glimmer of light at the end of the tunnel. If the referral system works effectively, insolvent patients from remote, rural areas would receive specialised medical care in tertiary hospitals, which the commission envisages to be upgraded from district general hospitals. In the back referral part of the system, patients could receive rehabilitation services in the initial health centres after they receive specialised treatment in tertiary hospitals.

A commission member says that there are plans to develop a network of general practitioners to initially respond to patients. No patient but in case of emergencies can visit a specialist or specialised hospitals without referral. The restriction would save patients unnecessary hospital visits and money on avoidable diagnostic tests and medical expenditure. The commission also envisages the availability of at least two people with MBBS degrees to work as family care physicians or one family care physicians per 15,000 people at union health centres in rural areas and at wards in urban areas. The Bureau of Statistics in a survey made public on March 20 shows that 91.3 per cent of respondents want primary health care to be recognised as a constitutional right. And, experts believe that the constitution should make citizens’ primary health care legally-binding for the government. The commission on constitutional reforms on January 15 recommended that the right to health should be implemented based on the ‘availability of resources’ with a commitment to ‘progressive realisation.’ The commission on health-sector reforms notes that it would propose that the government should be legally bound to ensure citizens’ primary health care. And, the basic emergency care should be free even if the patients receive the services in private hospitals.

Most of the propositions that have come to light appear well-meaning steps towards an effective reform of the health care system, but the government needs to show the will to carry out the reforms in the first place.​

 

[Saif]

Medical sector projected to reach $23b

Experts at a session on Thursday urged the investors to invest in Bangladesh’s medical sector as it is experiencing robust growth...

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Medical sector projected to reach $23b
Bangladesh Sangbad Sangstha . Dhaka 10 April, 2025, 22:23

Experts at a session on Thursday urged the investors to invest in Bangladesh’s medical sector as it is experiencing robust growth.

They also projected that the market volume will reach $23 billion by 2033, driven by increasing demand for medical consumables and advanced diagnostic tools.

They made the projection at a session on ‘Unlocking Healthcare Investment Potential in Bangladesh’ of the ‘Bangladesh Investment Summit 2025’ at a hotel in the city.

Md Saidur Rahman, secretary of the Health Services Division, was speaker of the session while Sylvana Quader Sinha, founder, chair and CEO of Praava Health delivered the keynote speech on ‘Unlocking Healthcare Investment Potential in Bangladesh’.

In his speech, Saidur Rahman described the remarkable growth of the country’s health sector and urged the investors to invest here.

‘It’s projected that the market volume of the country’s health sector will be $23 billion by 2033. It is clear that there are huge potentials for investors of the country’s health sector,’ he added.

Sylvana Quader Sinha said that the medical equipment and devices market was experiencing robust growth, driven by increasing demand for medical consumables and advanced diagnostic tools.

‘The sector is heavily reliant on imports, creating a significant opportunity for local manufacturing of medical devices, especially as the country works towards self-sufficiency in producing critical healthcare products. Investment potential exists in establishing manufacturing units for essential medical consumables, like in vitro diagnostic test kits, and low-risk health monitoring devices, and leveraging the B2C model to address the rising demand for consumables. As the health complexity increases, the demand for OT support and ICU equipment is also increasing, presenting the sector as a lucrative segment for investment with high returns,’ she added.

The founder of Praava Health said that healthcare had become one of the largest sectors of the Bangladeshi economy, in terms of revenue, it has been growing at a CAGR of 10.3 per cent since 2010, employing nearly 0.3 million people directly.

‘Several factors are driving the growth of the healthcare sector, including an aging population, a growing middle and affluent class, and the rising proportion of non-communicable diseases. The healthcare industry of Bangladesh comprises five prime subsectors: Healthcare Facilities, Pharmaceuticals, Medical Equipment and Devices, Digital Healthcare and Medical Biotechnology,’ she added.

Sylvana said that the country’s healthcare facilities are expanding with private hospitals, clinics, and diagnostic centres showing strong growth.

‘Public-private partnerships (PPP) and government incentives are encouraging investments. The sector benefits from policies like tax exemptions for private hospitals outside major cities, making it an attractive market for both local and foreign investors. The ongoing need for tertiary and specialized healthcare services in urban cities and the demand for primary healthcare in rural areas enhance the sector’s growth potential, positioning it as a key segment to invest in,’ she added.

She said that the pharmaceutical sector, recognised as a Pharmerging Market, is projected to reach $6 billion in 2025 at a 12 per cent compound annual growth rate (CAGR).

The industry is well known for branded generics-particularly in gastrointestinal, antibiotic and antipyretic therapies that quenches nearly all the domestic demand, she added.

Sylvana Quader said that digital transformation was further accelerating the growth in the healthcare sector. Since COVID-19, digital health has emerged as a key area of innovation, gaining momentum as the tech-savvy youth population increasingly turns to digital solutions for healthcare access.

The government’s Digital Healthcare Strategy 2023-2027 aims to integrate digital tools like cloud-based Electronic Health Records (EHRs) and telehealth platforms to enhance healthcare delivery and reduce costs, she continued.

She said that this transition presented investment opportunities in cloud-based services, interoperable health systems, and remote patient monitoring.

Additionally, partnerships with foreign tech companies for disease management solutions and healthcare technology innovations will be crucial in driving the sector’s growth, she added.​

 

[Saif]

Transforming Bangladesh into a healthcare hub

Bangladesh, one of South Asia’s fastest-growing economies, holds immense potential in the healthcare sector. However, the country’s health system currently faces several critical challenges — particularly the high cost of treatment, increasing patient outflow to foreign countries, the rising...

www.newagebd.net

Transforming Bangladesh into a healthcare hub
Syed Akram Hussain 11 April, 2025, 00:00

Bangladesh, one of South Asia’s fastest-growing economies, holds immense potential in the healthcare sector. However, the country’s health system currently faces several critical challenges — particularly the high cost of treatment, increasing patient outflow to foreign countries, the rising burden of cancer and chronic diseases, and heavy reliance on imported medical equipment and pharmaceuticals. According to the World Health Organization, government spending on health in Bangladesh was only 2.3 per cent of GDP in 2023, which is lower than the South Asian average of 3.4 per cent. On the other hand, an estimated $700 million in foreign currency is spent annually on treatment abroad. In this context, foreign and joint investments in Bangladesh’s healthcare sector are both timely and justified.

As a densely populated and rapidly growing country, Bangladesh offers significant potential for investment in healthcare. Each year, hundreds of thousands of patients seek treatment in countries such as India, Singapore, and Thailand, as well as the Middle East, Australia, and the United States. This leads to massive foreign currency outflow and places quality healthcare out of reach for many. Establishing world-class hospitals, cancer centres, transplant surgery facilities, and trauma rehabilitation centres in Bangladesh could drastically change this reality. The student and mass movement of August 2024, which resulted in numerous injuries, underscored the urgent need for dedicated trauma and injury rehabilitation facilities. This experience has made it clear — now is the time to invest in this critical sector.

Spotlight on visionary leadership

THE Investment SUMMIT 2025 was further elevated by the outstanding performance and strategic insights of Ashik Chowdhury, whose vision and coordination were instrumental in bringing together stakeholders across public and private sectors.

Special recognition also goes to Nobel Laureate Dr Muhammad Yunus, whose presence and commitment to social business innovation inspired all participants to reimagine healthcare as a human right and a scalable investment opportunity. Their contributions have set a high benchmark for future collaboration and innovation.

Priority areas for investment

Multi-super specialty hospitals: Establishment of international-standard facilities for complex care such as cancer, cardiology, neurology, and transplant surgery.

Cancer treatment centres: With approximately 150,000 new cancer cases diagnosed annually, each division in the country requires a modern, globally accredited cancer centre.

Transplant surgery centres: Kidney, liver, and bone marrow transplant facilities remain limited. Establishing full-scale transplant centres will reduce the need for overseas treatment.

Trauma and injury rehabilitation centres: Road accidents, political unrest, and natural disasters necessitate urgent and effective rehabilitation infrastructure.

Medical device manufacturing: Local production of technologically advanced equipment can reduce costs and create export potential.

Pharmaceutical research and export: Bangladeshi medicines are globally recognised. Increased investment in research and production will further boost exports.

Call for global collaboration

WE INVITE globally ranked medical universities, academic health centres, teaching hospitals, and pharmaceutical corporations to explore joint collaborations with local institutions in Bangladesh. This includes:

Establishing branch campuses or twinning programmes with Bangladeshi medical schools.

Setting up clinical research partnerships in oncology, non-communicable diseases, and advanced therapeutics.

Launching technology transfer hubs in diagnostics, AI in health, and precision medicine.

Co-investing in centres of excellence for cancer care, trauma rehabilitation, and transplant services.

Creating incubators for health startups in collaboration with local entrepreneurs and investors.

Such collaborations will not only provide high returns but also ensure meaningful social impact by building capacity and reducing global health inequity.

Attracting international patients

MILLIONS across the globe are seeking affordable, high-quality medical care. India and Thailand have already capitalised on this through strong medical tourism markets. Bangladesh, too, can tap into this opportunity by ensuring international standards of care, skilled professionals, clean environments, advanced technology, and digital referral systems. Expatriate Bangladeshis from the Middle East, USA, Canada, and Australia are especially likely to return for treatment. Simplifying medical visa processes, introducing airport-to-hospital shuttles, and creating package-based medical tourism offers will further attract foreign patients.

Medical devices and equipment production

ACCORDING to data from the Directorate General of Health Services and the Ministry of Commerce, Bangladesh imports an estimated $1.5 to 2 billion worth of medical devices, radiotherapy machines, and diagnostic tools annually. Producing these locally would not only save massive foreign currency but also open export markets. Currently, most critical medical equipment, including cancer therapy and surgical tools, are imported. With the right technology and public-private partnerships, Bangladesh can develop its own manufacturing capacity. Countries like India, China, and Malaysia have already captured a significant share of this global market. With relatively low labour and production costs, Bangladesh is well-positioned to become a medical device exporter. According to Allied Market Research, the global medical device market was valued at $570 billion in 2023 and is projected to reach $800 billion by 2028.

Opportunity for foreign investment in pharmaceuticals


BANGLADESH’S pharmaceutical industry is thriving, with exports to more than 150 countries. However, greater research and international investment are needed for developing innovative drugs—particularly for cancer, diabetes, heart disease, and rare diseases. Collaborations between domestic and international pharmaceutical companies could accelerate this growth. Such partnerships would generate employment, facilitate technology transfer, and ensure high-quality local production. This would also reduce drug prices and enhance competition in the domestic market. According to Business Monitor International, Bangladesh’s pharmaceutical export market reached $2.1 billion in 2023, growing at a rate of 8–10 per cent annually. With TRIPS waiver benefits extended until 2033, Bangladesh can manufacture patented medicines without restriction, making it a highly attractive destination for pharmaceutical investment.

Potential benefits

Saving billions in foreign currency annually.

Ensuring access to world-class healthcare domestically.

Generating millions of new jobs in the health, pharma, and equipment sectors.

Establishing Bangladesh as the healthcare hub of South Asia.

Improving international investor confidence and economic ratings.

Conclusion

INVESTING in healthcare in Bangladesh is a strategic decision — one that can significantly impact public health, the national economy, and the country’s global standing. With defined policies, structured partnerships, and a long-term roadmap, Bangladesh has the potential to emerge as South Asia’s premier medical hub. For development partners and investors, this is a high-impact opportunity where humanitarian value, profitability, and social responsibility intersect.

Professor Dr Syed Akram Hussain is a member of Health Sector Reform Commission.​

 

[Saif]

icddr,b launches advanced genome sequencing-based cancer diagnostics in Bangladesh

icddr,b has launched its Next-Generation Sequencing (NGS)-based cancer diagnostic service, making a major step forward in making precision cancer care more accessible and affordable in Bangladesh. Offered by the icddr,b Genome Centre, this is the most comprehensive molecular testing service of its

thefinancialexpress.com.bd

icddr,b launches advanced genome sequencing-based cancer diagnostics in Bangladesh
FE Online Report
Published :
Apr 23, 2025 16:48
Updated :
Apr 23, 2025 16:48

icddr,b has launched its Next-Generation Sequencing (NGS)-based cancer diagnostic service, making a major step forward in making precision cancer care more accessible and affordable in Bangladesh.

Offered by the icddr,b Genome Centre, this is the most comprehensive molecular testing service of its kind in the country, developed to support cancer specialists with faster, more accurate, and locally available diagnostics to guide personalised treatment plans.

The initiative addresses a longstanding call from Bangladesh’s cancer specialist community to reduce dependence on overseas laboratories, according to icddr,b.

Currently, many patients wait four to five weeks for results, often at high cost and with questionable report quality. In contrast, icddr,b will deliver reports in less than two weeks, backed by internationally trained experts, cutting-edge equipment, and globally benchmarked standards, it added.

“We are taking a transformative step toward accessible and precise cancer care in Bangladesh,” said Dr Md Mustafizur Rahman, Senior Scientist and Acting Senior Director, Infectious Diseases Division at icddr,b, adding that “We are ensuring the highest quality through globally trained professionals, rigorous validation, and world-class infrastructure. Our commitment is to provide cancer specialists and patients with timely, trusted insights that can make all the difference in cancer care.”

The service was developed under the leadership of Dr Tahmeed Ahmed, Executive Director of icddr,b, who envisioned the Genome Centre as a strategic initiative to strengthen national cancer care.

“This was a gap we could not ignore,” said Dr Tahmeed. “Our goal is to ensure no patient has to wait weeks or travel abroad for critical test results. We invite cancer specialists to work with us to bring this service to more people who need it most. This is not just a service—it’s a promise to deliver hope, trust, and better outcomes for all parties in cancer treatment and management in Bangladesh.”

This announcement builds on the momentum of a high-level visit to the icddr,b Genome Centre on 12 December 2024 by the Oncology Club of Bangladesh, and joined by members of the Lancet Oncology Editorial Board, and SAARC cancer specialists attending the Bangladesh International Cancer Congress.

The delegation praised icddr,b’s efforts to build world-class diagnostic capacity and advance cancer care in Bangladesh.

A 2025 nationwide study by BSMMU found that cancer affects over 100 in every 100,000 people in Bangladesh, with breast, oral, stomach, throat, and cervical cancers being the most common. Many patients facing delays in diagnosis, early and reliable testing is essential.

The icddr,b Genome Centre is well positioned to play a vital role in improving outcomes and reducing the national cancer burden. It offers testing for breast, lung, colon, ovarian, and blood cancers, enabling doctors to intervene when treatment is most effective.

To facilitate patient access, samples will be collected from any of the icddr,b Diagnostics Centres and booths in Mohakhali, Mirpur, Motijheel, Dhanmondi, Uttara, Niketon, Gulshan, and Baridhara.​