Saif
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A year of disruptions for health sector
Health services faced disruptions throughout the year, as shortages of medicines, equipment and contraceptives left thousands of people without much-needed care following the scrapping of a decades-long operational arrangement.
A year of disruptions for health sector
Scrapping of programme, medicine shortage deprived thousands of much-needed care
Health services faced disruptions throughout the year, as shortages of medicines, equipment and contraceptives left thousands of people without much-needed care following the scrapping of a decades-long operational arrangement.
Troubles began with the sudden halt of USAID funding in January, which affected the health sector -- both directly and indirectly. One immediate setback was the suspension of icddr,b's Alliance for Combating Tuberculosis, which was aimed at improving the tuberculosis case detection mechanism.
In the latter part of the year, public medical facilities witnessed protests by health workers pressing for a wide range of demands. Amid mounting pressure, the government promoted over 6,000 doctors, mostly to supernumerary posts.
Meanwhile, dengue continued to take a heavy toll on human lives, stretching the public health facilities to their limits. Influenza infection rate hit 59.2 percent in July -- the highest since surveillance of the disease began in 2007.
Adding to the concerns, the Multiple Indicator Cluster Survey 2025, released last month, revealed that the Total Fertility Rate (TFR) rose to 2.4 from 2.3 in the previous survey. This marks the first increase in TFR in five decades.
Despite extensive discussions on the urgent need for health sector reforms, progress remained elusive. A high-powered commission submitted a report recommending sweeping changes, but efforts to implement those were hardly visible.
Prof Be-nazir Ahmed, a health expert and former director of disease control at DGHS, said that though the sectoral programmes had some shortcomings, Bangladesh performed reasonably well in preventive healthcare through them over the last few decades.
"But the sudden halt to the programmes has put many of our hard-earned achievements -- such as the country's success in eliminating Kala-azar [a life-threatening parasitic disease] -- at risk of reversal," he told The Daily Star.
The interim health administration could have set an example by simultaneously taking two measures -- preventing corruption and sustaining or improving public health services.
But it could not to do so, creating a serious gap in service delivery, which will be difficult for the next administration to overcome, he added.
Prof Rashid E Mahbub, a medical expert and former president of the Bangladesh Medical Association (BMA), said the administration failed to provide an alternative plan following the suspension of the sectoral programmes, which resulted in service disruptions.
SERVICE DISRUPTIONS
Since 1998, the health ministry has implemented four Health, Population, and Nutrition Sector Programmes (HPNSPs) to provide a range of health, nutrition and family planning services, with the last one ending in June 2024.
The interim government scrapped the proposed fifth HPNSP and decided to integrate the sectoral programmes into regular ones to improve coordination and strengthen infrastructure.
The ministry took up several projects to complete the unfinished tasks of the Fourth HPNSP and to continue the supply of medicines and other emergency items. Though some projects were approved last month, many health services were disrupted for months, depriving thousands of essential care.
For example, there were disruptions in the supply of five types of medicines for diabetes and hypertension to 430 hospitals, mostly at the upazila level. The supply has yet to return to normal, even though the government recently allocated Tk 100 crore for the service, according to a health official.
Moreover, around 14,500 community clinics, which provide care to 490,000 people a day, saw disruptions in medicine supply throughout the year. No drugs were procured between July 2024 and May 2025 due to a fund crunch after the expiry of the HPNSP, severely affecting the supply of 22 types of medicines.
Though drug supply from the centre was fully restored in August this year with block allocations, procurement was halted in November due to various complications, said an official.
Regarding the disruption, Health Secretary Saidur Rahman said it took time to approve several projects to continue the supply. The situation will gradually become normal.
Health services and vaccination programmes also faced disruptions in November, as several sections of medical professionals demonstrated to press home their demands.
DOCTORS' PROMOTIONS
The interim health administration received praise for its decision to promote more than 6,000 doctors. But around 5,000 of them were placed in supernumerary posts, which are temporary positions created outside the regular structure.
Allegations were raised that many doctors were deprived of promotions this time as well due to political reasons.
Prof Rashid said it was commendable that the administration promoted many doctors who had been waiting for a long time. However, the existing health infrastructure is not adequate to absorb services from the promoted doctors, and the government does not have the necessary plan in this regard.
Asked, Saidur Rahman admitted that they would not be able to post all assistant and associate professors to medical colleges due to a lack of available posts. In such cases, they would have to work in hospitals.
Asked about the allegation that doctors affiliated with the pro-Awami League doctors' association were not promoted, he said, "Not everyone will get a promotion, and there are various reasons for that."
LITTLE PROGRESS IN REFORMS
In May, the Health Sector Reform Commission, led by National Professor AK Azad Khan, recommended a sweeping overhaul of healthcare management, but the government did not initiate any major reform.
In its report, the commission suggested that the government make primary healthcare a constitutional obligation and provide it free of cost to ensure universal access.
When asked, Saidur Rahman said the ministry implemented some minor reforms, but made little progress on major ones. "We have tried our best but it's a big sector with a lot of challenges."
Prof Be-nazir Ahmed said that had the interim administration initiated the process of implementing the recommendations properly, the next government could have carried it forward.
"But given the current situation, the next government will have to review them and start the process afresh, which will take a long time, he added.
Scrapping of programme, medicine shortage deprived thousands of much-needed care
Health services faced disruptions throughout the year, as shortages of medicines, equipment and contraceptives left thousands of people without much-needed care following the scrapping of a decades-long operational arrangement.
Troubles began with the sudden halt of USAID funding in January, which affected the health sector -- both directly and indirectly. One immediate setback was the suspension of icddr,b's Alliance for Combating Tuberculosis, which was aimed at improving the tuberculosis case detection mechanism.
In the latter part of the year, public medical facilities witnessed protests by health workers pressing for a wide range of demands. Amid mounting pressure, the government promoted over 6,000 doctors, mostly to supernumerary posts.
Meanwhile, dengue continued to take a heavy toll on human lives, stretching the public health facilities to their limits. Influenza infection rate hit 59.2 percent in July -- the highest since surveillance of the disease began in 2007.
Adding to the concerns, the Multiple Indicator Cluster Survey 2025, released last month, revealed that the Total Fertility Rate (TFR) rose to 2.4 from 2.3 in the previous survey. This marks the first increase in TFR in five decades.
Despite extensive discussions on the urgent need for health sector reforms, progress remained elusive. A high-powered commission submitted a report recommending sweeping changes, but efforts to implement those were hardly visible.
Prof Be-nazir Ahmed, a health expert and former director of disease control at DGHS, said that though the sectoral programmes had some shortcomings, Bangladesh performed reasonably well in preventive healthcare through them over the last few decades.
"But the sudden halt to the programmes has put many of our hard-earned achievements -- such as the country's success in eliminating Kala-azar [a life-threatening parasitic disease] -- at risk of reversal," he told The Daily Star.
The interim health administration could have set an example by simultaneously taking two measures -- preventing corruption and sustaining or improving public health services.
But it could not to do so, creating a serious gap in service delivery, which will be difficult for the next administration to overcome, he added.
Prof Rashid E Mahbub, a medical expert and former president of the Bangladesh Medical Association (BMA), said the administration failed to provide an alternative plan following the suspension of the sectoral programmes, which resulted in service disruptions.
SERVICE DISRUPTIONS
Since 1998, the health ministry has implemented four Health, Population, and Nutrition Sector Programmes (HPNSPs) to provide a range of health, nutrition and family planning services, with the last one ending in June 2024.
The interim government scrapped the proposed fifth HPNSP and decided to integrate the sectoral programmes into regular ones to improve coordination and strengthen infrastructure.
The ministry took up several projects to complete the unfinished tasks of the Fourth HPNSP and to continue the supply of medicines and other emergency items. Though some projects were approved last month, many health services were disrupted for months, depriving thousands of essential care.
For example, there were disruptions in the supply of five types of medicines for diabetes and hypertension to 430 hospitals, mostly at the upazila level. The supply has yet to return to normal, even though the government recently allocated Tk 100 crore for the service, according to a health official.
Moreover, around 14,500 community clinics, which provide care to 490,000 people a day, saw disruptions in medicine supply throughout the year. No drugs were procured between July 2024 and May 2025 due to a fund crunch after the expiry of the HPNSP, severely affecting the supply of 22 types of medicines.
Though drug supply from the centre was fully restored in August this year with block allocations, procurement was halted in November due to various complications, said an official.
Regarding the disruption, Health Secretary Saidur Rahman said it took time to approve several projects to continue the supply. The situation will gradually become normal.
Health services and vaccination programmes also faced disruptions in November, as several sections of medical professionals demonstrated to press home their demands.
DOCTORS' PROMOTIONS
The interim health administration received praise for its decision to promote more than 6,000 doctors. But around 5,000 of them were placed in supernumerary posts, which are temporary positions created outside the regular structure.
Allegations were raised that many doctors were deprived of promotions this time as well due to political reasons.
Prof Rashid said it was commendable that the administration promoted many doctors who had been waiting for a long time. However, the existing health infrastructure is not adequate to absorb services from the promoted doctors, and the government does not have the necessary plan in this regard.
Asked, Saidur Rahman admitted that they would not be able to post all assistant and associate professors to medical colleges due to a lack of available posts. In such cases, they would have to work in hospitals.
Asked about the allegation that doctors affiliated with the pro-Awami League doctors' association were not promoted, he said, "Not everyone will get a promotion, and there are various reasons for that."
LITTLE PROGRESS IN REFORMS
In May, the Health Sector Reform Commission, led by National Professor AK Azad Khan, recommended a sweeping overhaul of healthcare management, but the government did not initiate any major reform.
In its report, the commission suggested that the government make primary healthcare a constitutional obligation and provide it free of cost to ensure universal access.
When asked, Saidur Rahman said the ministry implemented some minor reforms, but made little progress on major ones. "We have tried our best but it's a big sector with a lot of challenges."
Prof Be-nazir Ahmed said that had the interim administration initiated the process of implementing the recommendations properly, the next government could have carried it forward.
"But given the current situation, the next government will have to review them and start the process afresh, which will take a long time, he added.
































