Bangladesh's achievements in many areas of human development have been remarkable. It has received plaudits from home and abroad for this, from time to time.
The country has done well in bringing down the maternal and infant mortality rates and building physical infrastructure even up to the grassroots level.
However, it has a long way to go in developing an efficient and pro-people healthcare system. The number of doctors, nurses and hospital beds still are too inadequate to meet the requirement of a population of 170 million. Nor does it spend enough on healthcare considering it a priority area.
An individual is now required to meet nearly 70 per cent of medical expenses out of his/her own pocket. The global average of such expenditure is 32 per cent.
Moreover, the available public sector health facilities can meet the medical needs of the population partially. The vast majority of the people are still dependent on the private hospitals and clinics that are expensive.
Poor and low-income people are left with no option other than seeking medical help from the government hospitals and clinics. They know the help is hard to come by. Yet they crowd these facilities.
Though policymakers do claim big achievements in the health sector, they appear to be reluctant to meet the financial needs of the health sector. What is even worse is that they are indifferent to wastage and misappropriation of the paltry amountallocated in national budgets for the health sector.
The funds allocated for health sector in the annual budgets are highly inadequate. In the past few years, the allocation to the health sector had been around 5.0 per cent of the total budget. Earlier, the allocation was even less. The WHO (World Health Organisation) suggests a minimum allocation equivalent to 15 per cent of the total budget size.
The expenditures on health are less than 1.0 per cent of the country's gross domestic product (GDP), the lowest in South Asia. This reflects the fact that the government is not responsive to the needs of the health sector despite the fact that it is one of the top priority areas in the government policy papers. When we talk about high economic growth, it is hard to ignore the physical well-being of the population. Physical fitness is an important element in a nation's pursuit for prosperity.
Until the outbreak of coronavirus, most people here were talking about dearth of medical facilities for treating non-communicable diseases against the backdrop of continuous rise in the number of heart, kidney and cancer patients. None seemed concerned about the country's preparedness for handling any major outbreak of any communicable disease.
Coronavirus outbreak has exposed everybody to the grim reality---Bangladesh like many other countries has not taken necessary preparation to face a major outbreak of any communicable disease.
However, that the country is ill-prepared to handle even the outbreak of a vector-borne disease such as dengue came to the fore last year. Dengue had for the first time travelled to remote places last year and claimed many lives. The authorities then seemed clueless about meeting a health emergency.
This time the crisis is unprecedented. Even the developed nations having all the resources and modern medical knowledge and expertise at their disposal are found to be helpless against the virusattack.
It is truly regrettable that Bangladesh does not have the ability even to test the corona suspects and offer medical facility to COVID-19 patients. That the Institute of Epidemiology, Disease Control and Research Centre (IEDCR) is in a mess is now very much apparent. Though the ministry of health has been putting up a bold face in public about its capacity to handle the situation, the fact remains that it does not know what would unfold in the coming weeks.
The prevailing situation should teach the policymakers an important lesson--- the country's health sector needs greater attention in the matters of allocation of resources and their proper use.
Both preventive and curative aspects of healthcare should get equal emphasis. More importantly, the control and prevention of communicable diseases should get attention on a priority basis from all concerned. It will also be important to ensure participation of private health facilities at the time of national emergencies.
There is no denying that the government would play the lead role in the case of health emergencies. But since the private sector does play a dominating role in the health sector, it would not be wise at all to keep them away. Thus, it will be important on the part of the government to draw a strategy on ways to meet health emergencies such as the ongoing one.
It will not be out of place here to mention that a substantial part of the resources allocated in the annual budget is either wasted or misappropriated by a section of officials and staff of government hospitals and the DGHS. The stories about procurement of goods and medical equipment at exorbitant costs are plenty. Besides, there are allegations about many expensive medical equipment remaining unused for years. Despite scores of media reports, the situation has remained unchanged, unfortunately. Actionhas to be taken here by the relevant authorities.
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