As we reflect on the journey of Bangladesh and the recent events, it's essential to remember the sacrifices made by the martyrs and the youth of our nation. Their courage, resilience, and unwavering commitment to justice have laid the foundation for a new Bangladesh—one that aspires to uphold the values of equality, progress, and social welfare. 

The healthcare sector was tested throughout the months of July and August, and the injured patients flocked to the nearby facilities. It was reported by national newspapers and healthcare seekers, that some healthcare facilities of our country denied treatment to injured patients. This is a grave violation of human rights and we believe regulatory authorities will ensure proper action against such incidents. At the same time, there were several healthcare professionals, agencies and institutions who risked their own lives to serve the injured patients, they stood by their oath, and they demanded our respect for serving mankind. 

As the country is navigating to the right course, the interim government led by Dr. Mohammad Yunus has the unique opportunity to lay the groundwork for long-term reforms that can significantly improve critical and essential sectors like healthcare. For the Health Adviser Nurjahan Begum, the role should be to initiate and implement key reforms. The focus should be given on strengthening regulatory frameworks, launching nationwide public awareness campaigns, improving access to essential services, fostering partnerships and laying the foundation for long term reforms.  

The ways through which the interim government can bring positive changes to the healthcare sector:

Strengthen Regulatory Frameworks 

• Update and Enforce Regulations: Ensure proper updates of outdated healthcare regulations, particularly those related to private healthcare facilities and pharmaceutical practices can curb unethical practices, such as over-prescription of antibiotics and overcharging for diagnostic tests. A stronger regulatory framework will help in maintaining the quality of healthcare services and protecting patients from exploitation.

• Enhance Licensing of Pharmacies: Strengthening the licensing and accreditation processes for healthcare providers, including pharmacies and diagnostic centers, can ensure that only qualified professionals are allowed to operate. This can reduce the risk of AMR due to improper drug dispensing and improve the overall quality of care. 

• Introduce incentive fund for Health Sector: To ensure the decentralization of the healthcare facilities, a separate fund can be created for private health sector companies if they are willing to operate in the remote areas of the country.

• Ensure proper facilities for Healthcare Professionals: The facilities provided to the healthcare professionals and medical students are not satisfactory which has been outlined in multiple protests. It is necessary for the interim government to address the concerns of the resident doctors, ensure proper healthcare delivery mechanism and address the mismanagement in Medical Admission tests. 

Launch Nationwide Public Awareness Campaigns

• • • • Mental Health Awareness: The current events, protests, bloodshed and sound of grenades have caused severe mental health concerns among the citizens. To ensure the citizen’s lead a healthy life, and can focus on daily activities, it is necessary for the government to ensure proper mental health care services. Leading nationwide campaigns to raise awareness about mental health, reducing stigma, and encouraging more people to seek help by collaborating with media outlets, educational institutions, and community organizations should be introduced. 

      • Awareness on AMR and Over the Counter Drug Sale: Public awareness campaigns about the dangers of antibiotic misuse are essential to combat AMR. These campaigns can educate the public on the importance of following medical advice and discourage self-medication practices. It can also empower the local communities to ensure that the rate of Over the Counter drugs sale is minimized. 

Improve Access to Essential Services

• • • • Expand Mental Health Services: Prioritization of the expansion of mental health services, including the establishment of a national 24/7 mental health helpline. 

• • • • Ensure Healthcare Professional Availability: During the nationwide protests, the healthcare professionals were heavily tasked to save the lives of the injured. The scarcity of doctors put the entire healthcare sector in jeopardy. It is necessary for the private and public healthcare facilities to increase their healthcare professionals along with the number of doctors and nurses. 

• • • • Extend Diagnostic Service Hours in Public Hospitals: To reduce the financial burden on households, the operating hours of diagnostic services in public hospitals can be extended. 

Foster Partnerships and Collaborations

Seeking support from international organizations, such as the World Health Organization (WHO) and global health bodies, to gain technical expertise and funding for healthcare reforms. Partnerships with international NGOs can also help in the implementation of pilot projects that could be scaled up nationally. The interim government can engage with the private healthcare sector to encourage collaboration on key initiatives, such as expanding mental health services or reducing the cost of diagnostic tests. Public-private partnerships can be instrumental in addressing gaps in service delivery and improving healthcare quality.

Lay the Foundation for Long-term Reforms

While immediate actions are necessary, the interim government should also focus on laying the foundation for long-term healthcare reforms. This includes initiating policy changes, setting up task forces to address specific issues like AMR, and ensuring that future governments have a clear roadmap to follow. Also, the introduction of a social health insurance scheme could drastically reduce OOP costs and make healthcare more accessible to all citizens. This initiative would be a critical step towards achieving universal health coverage in Bangladesh.

• Strengthening Urban Primary Health Care Facilities: The urban healthcare facilities of Bangladesh have been in a dire state which leads to increased pressure on the tertiary facilities. During the protest, many injured patients in Dhaka did not receive emergency and life saving healthcare facilities in their local hospital, thus they had to be rushed to Dhaka Medical College. Effective management and healthcare delivery have to be ensured in primary healthcare facilities so that such incidents do not repeat in the future. 

• Reforms in Tax mechanism related to healthcare services: Medical instruments and Operation Theatre (OT) tables and lighting systems should be considered as capital machines and the tax has to be minimized. Medical instruments taxes were at 37% whereas OT equipment were taxed 15-31% (Shamim, 2024). The Private Health Sector does not receive subsidies like public companies, the interest rate on bank loans for the private health sector has to be set. The corporate tax has to be reduced for private healthcare companies and diagnostic centers which are operating in remote regions and regions like Chittagong Hill Tracts, Sundarbans  etc.

• Focus on Development Budget: The health sector development receives only one-third of the annual health budget, the rate of utilization of the health development budget has also decreased over the years (from 94% in FY12 to 78% in FY22). Proper utilization of the development budget has to be ensured and past budgets should be reviewed.

• Promote international accreditation for healthcare facilities: International accreditation is pivotal for high-quality healthcare, but it is also a time-consuming and expensive endeavor. Therefore, a 5% tax rebate can be offered to companies that gain international accreditation. The tax rebate has already shown significant success in the Ready Made Garments Industry. 

The healthcare sector of Bangladesh is at a critical juncture, and the interim government has the power to steer it towards a path of reform and improvement. By addressing the key challenges  and strengthening the healthcare institutions, Bangladesh can achieve a healthier future for all its citizens. The time to act is now, and the sacrifices of our past must inspire us to create a brighter, healthier tomorrow where every citizen receives universal health coverage.

The news of the heinous incident at R G Kar Medical College Hospital in Kolkata has shocked our hearts, brought us to tears. We believe health is a universal right and anyone providing the healthcare service is serving humanity. We demand justice for Dr. Moumita Debnath

References 

Huque, Rumana, Syed A. Hamid, Aminul Hasan, and Hossain Z. Rahman. 2024. “Health Sector Budget of 2024-25 | How healthy is the health budget?” The Daily Star, June 30, 2024. https://www.thedailystar.net/opinion/views/news/how-healthy-the-health-budget-3644741

Shamim, A M. 2024. “Budgetary recommendations for Bangladesh’s health sector” The Business Standard, May 30, 2024.

https://www.tbsnews.net/thoughts/budgetary-recommendations-bangladeshs-health-sector-863881