Five recommendations for the health sector

Ahmed Mushtaque Raza Chowdhury

The development that Bangladesh has seen over the last couple of decades has given rise to a paradox. Despite poverty, disparity in income and problems in governance, the manner in which the country has advanced has been dubbed as a ‘paradox’ by experts. We have left many of our neighbours behind in this development race. Over the past one and a half years or so, we have been battling Covid-19. This battle has hit many powerful countries hard. Other than a handful of countries in Southeast Asia, most countries, including Bangladesh and others in South Asia, were unprepared. Just as we were overcoming the first wave, we were hit by the second wave and have been in this second wave for the past two months.

It is the norm of pandemics to come in waves, one after the other. Epidemiologists say the better the people understand these waves, the better they can tackle it. We have not forgotten the first wave. All sorts of efforts were taken up, though very few were implemented in a proper scientific manner. It is the same all over again. The lockdown that has been enforced can hardly be called a lockdown. Other than educational institutions, everything has been opened up, though officially we are still under lockdown.

Fortunately, the Covid situation has not gone out of our control. We are in a relatively better condition than India and some other neighbours. The million dollar question is, how come? How come we have been lesser affected by the spread of Covid? There is no accurate answer to this question. With no scientific explanation, we can just make assumptions.

It was a bold step to seal the border with India when the second wave hit. The halt of trains and long haul buses on the eve of Eid holidays also stemmed the spread of the virus to an extent. And then again there is the resilience of our people. People heeded advice of the physicians. There were online services for those unwilling to venture out.

I see Covid as a great opportunity for Bangladesh to refurbish its health system.

The government and the people must take further preparations before the third wave strikes.

Every cloud has a silver lining. After World War II in Europe, the countries built up a health system upon the devastation, where each and everyone was guaranteed free healthcare.

After a brutal genocide in the nineties, Rwanda built up its universal health coverage. I see Covid as a great opportunity for Bangladesh to refurbish its health system. Most experts are in consensus about what is to be done.

I would like to highlight five recommendations in this regard. One, a health commission is to be formed to draw up an outline for a nationwide health security programme and also to monitor its implementation. Two, establishing a national health security office which will keep separate the health ministry’s ‘purchaser role’ and ‘provider role’. Three, ensuring good governance and efficient management. Four, increasing priority of primary health care. Five, having adequate funds for research and increasing the skills of the relevant institutions.

* Ahmed Mushtaque Raza Chowdhury is former dean, BRAC School of Public Health

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