Dengue's economic toll in Bangladesh

In July 2025, twelve-year-old Joya from Barguna fell ill with what first seemed like a simple fever, but within days she was diagnosed with dengue and rushed to a private clinic in Barishal as public hospitals were overflowing. Her eight-day stay in the clinic, including time in intensive care, cost her family nearly Tk 200,000-more than six months of their family income-forcing them to borrow money and drain savings meant for her education. The family's long-held dream of sending Joya to a better school indefinitely postponed, a stark reminder that in Bangladesh dengue devastates not only health but also the fragile economic stability of ordinary households.

Every monsoon, Bangladesh braces itself for dengue. The mosquito-borne disease has long been an unwelcome seasonal visitor, but in recent years it has turned into a recurring national emergency. In 2025 alone, the country has already recorded over 24,000 confirmed infections and more than a hundred deaths by mid-August. What used to be an urban problem concentrated in Dhaka has spread to sixty districts, with hotspots like Barguna accounting for more than a quarter of total cases. The story, however, is not just about hospital wards filling up or daily death counts climbing. It is about the quiet but devastating economic fallout-one that hits households, the health system, and the national economy with equal force.

At the household level, dengue is a financial catastrophe. A study by the Bangladesh Institute of Development Studies found that the average cost of treating a single patient in Dhaka was Tk 33,817. For many families, that figure is more than an entire month's income. The poorest households suffered the worst, with some spending as much as 139 per cent of their monthly earnings to cover treatment. Parents pulled from savings, borrowed money, or sold off assets. For one family, an eight-day ICU stay cost Tk 248,993, even after a hospital discount. Another reported spending Tk 60,000 on medicine alone, delayed treatment having driven up expenses. These are not just numbers on a spreadsheet-they are stories of long-term economic burdens, of education deferred, of savings wiped out, of families pushed deeper into poverty.

Abu Zafar Saleh, a journalist from Barguna, shared his dire experience with Dengue. His entire family got infected by dengue. He had to spend two lacs for his two children including all medical and medicine expenses. The Barguna Sadar Hospital suggested sending the kids to Barisal Medical College, and Barisal Medical referred them to Dhaka. The hassle continued for several months. They are both mentally and economically exhausted.

The government too has been forced to dig deep. During the 2023 outbreak, Tk 4 billion was spent on dengue treatment-roughly Tk 50,000 per patient-borne mostly by public hospitals. That figure represents only the tip of the iceberg. The indirect economic losses-patients unable to work, caregivers absent from jobs, businesses disrupted-remain far harder to quantify but no less significant. Productivity dips ripple across industries, schools suffer attendance slumps, and in some cases, lives are cut short before their prime working years. Health economists warn that these premature deaths and prolonged illnesses carry a cost that stretches far beyond the hospital bill.

Yet the imbalance in government priorities is glaring. While billions are poured into treatment every year, preventive measures remain fragmented and underfunded. In 2018-19, Dhaka's two city corporations spent Tk 260 million and Tk 250 million respectively on mosquito eradication. But these efforts were disorganised and failed to keep pace with the scale of the outbreak. The World Health Organisation has repeatedly flagged this problem that without sustained, coordinated investment in vector control, public awareness, and early interventions, Bangladesh will remain trapped in a cycle of reaction rather than prevention.

The economic crisis is not limited to households or hospitals. Dengue undermines national resilience. As patients languish at home or in overcrowded wards, the workforce shrinks. Caregivers-often women-are pulled out of jobs, further weakening household income streams. Rising healthcare costs fuel public dissatisfaction, while global headlines about deadly outbreaks deter tourism and foreign investment. Dengue, once considered a tropical inconvenience, is now an obstacle to economic growth.

Climate change adds yet another layer of complexity. Hotter temperatures, longer rainy seasons, and increased humidity have created near-perfect breeding conditions for mosquitoes. Outbreaks are no longer confined to Dhaka and Chattogram but are now spread across all 64 districts. Rural areas, with their fragile healthcare systems, face the double burden of inadequate treatment capacity and spiraling costs of care. In these communities, the economic consequences are compounded: children miss school, workers lose daily wages, and families slip further down the ladder of economic mobility.

What, then, is the way forward? The answer lies in rebalancing the response. Dengue should not only be seen as a public health emergency but also as an economic crisis. Expanding healthcare infrastructure beyond urban centers can cut down on costly delays in treatment. Strengthening financial protection mechanisms-through subsidies or health insurance-would help shield vulnerable families from catastrophic spending. During epidemic peaks, private hospitals must step up, offering low-cost or even free treatment, much like the collective response seen during COVID-19. At the same time, investments in vector control and climate adaptation must no longer be afterthoughts in budget allocations.

The stakes are high. Without change, Bangladesh risks sleepwalking into a future where dengue drains not only lives but also livelihoods, year after year. The virus does not wait for budgets or bureaucracies.

Bangladesh has shown resilience before, whether in recovering from cyclones or mobilising against pandemics. It can do so again. But only if we stop seeing dengue as a seasonal inconvenience and recognise it for what it has become: a slow-burn economic emergency that is robbing families of stability and the nation of its strength. The time to act is not when hospitals overflow; it is now, before the next outbreak hits harder and costs more than we can afford.

Samar Roy, Director, Media Professionals Group. mediaprofessionals@gmail.com. Noushin Mouli Waresi works at Bangladesh Health Watch, Brac James P Grant School of Public Health.