Health security fares poorly in Bangladesh

Dengue has taken a serious toll on Bangladesh this year, yet the health ministry failed to project the outbreak in advance. The hospitals all over the country grappled to accommodate and treat the patients. The health officials were totally unprepared for the magnitude of the outbreak.

Bangladesh’s lack of preparedness in the health sector has been revealed in a global report on health security released this week.

The report said that Bangladesh’s preparedness to deal with emergencies is nil. The public health authorities and relevant quarters responsible for health security are totally lacking in coordination. There is no understanding with neighbouring countries over public health and diseases.

Bangladesh’s ranks 113 among 195 countries in the global health security index, with an average health security score of 35. The global average is 42.2. Among South Asian countries, India, Mynmar, Bhutan, Pakistan and Nepal score higher than Bangladesh.

The report, however, praises Bangladesh immunisation programme and laboratory system. Bangladesh also ranks well in following international health norms.

These facts and figures were revealed in the report, Global Health Security Index: Building Collective Action and Accountability 2019. The 324-page report was prepared by the Nuclear Threat Initiative, Johns Hopkins University’s Centre for Health Security, and the Economist Intelligence Unit. Bill and Melinda Gates Foundation, Open Philanthropy Project and Roberstson Foundation provided support for preparing the report.

The researchers said that health security is globally weak and no country is fully prepared to tackle the outbreak of an epidemic.

The report uses 34 indicators in covering six categories: prevention, detection and reporting, rapid response, health system, compliance with international norms and risk environment. On a scale of 100, the global average in this regard is 42.2. The US scores the highest at 83.4 and Equatorial Guinea the lowest at 16.2.

Bangladesh profile

Resistance to antibiotics is a global problem and Bangladesh’s performance in this regard is below average. Bangladesh has scored nil in 11 indicators including bio-security, bio-safety and infection control.

Bangladesh ranks poorly in planning and preparing for epidemics like the dengue outbreak. Communication between health workers and the public in emergency public health situations is poor. The capacity to test and approve new medical countermeasures is also nil.

At a recent meeting with the media, director of the Institute of Epidemiology, Disease Control and Research (IEDCR), Meerjady Sabrina said that they monitored influenza, dengue, Nipah, cholera, rotavirus, Japanese encephalitis, anthrax and antibiotic resistance. They monitor these through certain hospitals, incidents, the media, over mobile phone and hotlines.

However, a consultant of an international agency, remaining anonymous, said that while there are weaknesses in all countries of the world, the worst aspect in Bangladesh is that information is concealed. The government has not made public what had happened in the case of chikunguniya. It is the same about dengue. There is an acute lack of accountability.

The report made 33 recommendations. It said that the governments should commit to take action to address health security risks. The health security capacity in every country should be transparent and regularly measured. The results of the external evaluations and self-assessments should be published at least once every two years.

Former president of Bangladesh Medical Association, Rashid-e-Mahbub, speaking to Prothom Alo about the report findings, said “Only when there is an outbreak of any epidemic, we talk or think about health security. But at other times, we do not bother.”

He said the report has many new issues and indicators, but the policymakers and health scientists here do not have a clear idea about these matters. There is need for extensive discussion about these issues and the media can play a strong role in this regard.

* This report appeared in the print edition of Prothom Alo and has been rewritten in English by Ayesha Kabir