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Public health experts in Bangladesh have expressed concern about the government’s decision to charge people for Covid-19 tests amid a sharp decline in the number of tests being done, observed a report of The Lancet.
In late June this year, the government decided to charge Tk 200 for a coronavirus testing done at government facilities and Tk 500 for a sample collected from home to ‘avoid unnecessary tests,’ mentioned the report released on Vol 396 (August 29, 2020) of The Lancet world report.[ Full report is available at www.thelancet.com.]
It added that the private sector charges Tk 3,500 per test.
“Almost one in four Bangladeshis live below the national poverty line,” said the report. “Since the decision, testing rates have fallen to around 0•8 tests per 1000 people per day, with a low of just 0•06 tests per 1000 people in August.”
The global weekly medical journal also said that Bangladesh is administering on average between 12000 and 15000 tests per day for a population of 168 million, and has recorded almost 275,000 confirmed cases and more than 3600 deaths.
Lancet quoted Shamim Talukder, head of Eminence, a Bangladeshi public health research organisation as saying that the pandemic had exposed the country’s ‘unethical’ health-care system.
“From the beginning of the pandemic, the government wanted to control the Coivd-19 testing system”, he said. “At the beginning it didn’t allow the private sector to do the tests and now they’ve applied a charge for testing in the public sector, which just means that the poor are excluded.”
Talukder told The Lancet that he had visited multiple graveyards across Dhaka, where graveyard managers had told him the death rate from coronavirus was ‘four times higher’ than the recorded figure was.
Talukder added that many people had died of Covid-19 but had not been tested, or had died before they had received their test results.
Former Director of Bangladesh’s Institute of Epidemiology, Disease Control and Research Mahmudur Rahman, also quoted in The Lancet report, argued that charging people for tests is creating barriers, especially for the poor.
Other barriers to testing, Rahman told The Lancet, include the low trust people had in the health-care system.
“We’ve had testing scams here. There is a lack of confidence in the health-care system, so people don’t want to get tested because they don’t want to get a result they don’t trust”, he said.
Delay in getting the results is another problem, he mentioned.
In another note, Talukder told The Lancet that the country spends just 0•69 per cent of Gross Domestic Product (GDP) on the health sector, which makes Bangladesh one of the lowest spenders on health globally.
He added that two-thirds of health expenditure is out of pocket and borne by households, many of whom are propelled into poverty by catastrophic health-care costs.