Bangladesh defies stereotypes on the subject of well being care. Let's preserve it that manner

Sufferers line up for distant well being session classes close to Rangpur, Bangladesh. The nation has emerged as a mannequin of health-care progress within the International South.

Allison Joyce/Allison Joyce for NPR/2019 Allison Joyce

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Allison Joyce/Allison Joyce for NPR/2019 Allison Joyce

When individuals consider Bangladesh, they usually consider poverty. It was one of many world’s poorest nations when it was created in 1971. And so they in all probability consider political upheaval — this yr large protests led to the resignation of the prime minister. An interim authorities led by Nobel Prize winner Muhammad Yunus is now in place.

However Bangladesh defies the stereotypes. It has shortly moved as much as decrease middle-income standing (common earnings is roughly $2,500) and is on observe to be unlisted from the U.N. record of least developed nations by 2030.

Together with this rise from poverty, Bangladesh has made exceptional strides in bettering its well being care. Two statistics illustrate the extent of the progress.  

Life expectancy was roughly 58 years in 1990. By 2019, it had risen to 74 years. These figures are from a collection of studies published in The Lancet. And demise from all causes noticed a steep decline: from 1,500 deaths per 100,000 inhabitants in 1990 to 715 deaths in 2019.

What’s extra, these public well being accomplishments had been achieved in a rustic with a GDP per capita of two,688.31 U.S. {dollars} and a 2.36% well being expenditure as a share of the gross home product. For context, different lower-middle-income international locations spend 4% to 6% of their GDP on well being and are sometimes not capable of accomplish such dramatic enhancements.

I used to be born in Kashmir, so I do know the area properly. Throughout my medical coaching, I spent a number of years in Bangladesh’s Dhaka district. I used to be impressed by the mixture of forces which have led to enchancment in well being companies. With worldwide cooperation and funding, Bangladesh has established community-based efforts led by grassroots well being staff and a community of small well being facilities. These services present reproductive companies for ladies, they promote immunization they usually train about diet.

Dr. Tina Mustahid sees sufferers over video from her workplace in Dhaka, Bangladesh. She most frequently offers with gynecological and digestive points, joint ache, pores and skin ailments and fever.

Allison Joyce for NPR/2019 Allison Joyce

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A breakthrough in Bangladesh

Bangladesh can be the place the place the oral rehydration resolution was developed.

It sounds logical — giving a beverage manufactured from salts (particularly sodium and potassium), sugar and water to sufferers with extreme diarrhea to revive the fluids and vitamins they’ve misplaced. However the truth is the oral rehydration resolution was a exceptional innovation — and it was pioneered by Bangladeshi researchers Rafiqul Islam and Majid Molla from the Cholera Analysis Laboratory in Dhaka (now referred to as the the International Centre for Diarrhoeal Disease Research, Bangladesh — icddr,b, working with American physicians David Nalin and Richard Money.

Their findings confirmed that the necessity for intravenous fluids to deal with grownup cholera mother and father dropped by 80% in the event that they got oral rehydration resolution.

“Oral rehydration resolution is credited with saving greater than 50 million lives within the 20^th century,” stated international well being knowledgeable Thomas J. Bollyky, the Bloomberg Chair in International Well being on the Council on International Relations. The Lancet has hailed it as probably an important medical advance of the 20^th century.

The query that looms massive

However with political upheaval in Bangladesh, societal upheaval may ensue. So the query is: Can Bangladesh keep its function as a mannequin of well being developments within the International South — and tackle new well being challenges?

An ongoing precedence is to battle communicable ailments. The World Financial institution has partnered with Bangladesh for 50 years, committing around $40 billion in grants and favorable loans to make sure improved therapy, prevention and referral companies for infectious ailments, together with mosquito-borne diseases like dengue which can be on the rise on this time of local weather change at the same time as deaths from many infectious ailments like tuberculosis have decreased.

And new challenges are arising. Bangladesh is seeing an exponential improve in mortality from non-communicable sicknesses together with diabetes and Alzheimer’s — resulting in what epidemiologists check with as a “double burden.”

The nation can be working with a $200 million investment from the World Bank to enhance major well being care, similar to screening for hypertension. Authorised in August 2023, this program wants continued authorities assist to construct major health-care facilities and preserve monitoring packages on observe.

Extra health system challenges embody understaffed health-care services and prohibitive out-of-pocket bills that impede entry to equitable care.

WHO is already collaborating with the Ministry of Well being and Household Welfare in Bangladesh to create the primary national medical education strategy geared toward addressing the nation’s extreme scarcity of skilled health-care staff. They’re investing within the improvement of curriculum, accreditations and college.

International well being organizations have a historical past of supporting international locations throughout such vital occasions. Throughout the same political disaster in Sri Lanka in 2022, the International Fund to Battle AIDS, Tuberculosis and Malaria permitted $989,687 in emergency funding to make sure distribution of and entry to important medicines.

It’s vital that these teams play an important function throughout this transition in Bangladesh. The World Well being Group, UNICEF and nongovernmental teams that target well being and improvement should unite to guard the nation’s progress and maintain momentum on essential initiatives.

And they’ll have nice assist from the individuals of Bangladesh. I’ve witnessed their resilience and adaptableness. Throughout the infamous Rana Plaza building collapse in Savar that killed greater than a thousand garment manufacturing facility staff in 2013, I volunteered with the Worldwide Committee of the Pink Cross in Dhaka, offering fundamental medical care and instructing preliminary catastrophe administration methods to Bangladesh Pink Crescent Society employees members. Regardless that it was one of many worst industrial disasters the nation had confronted, and assets had been scarce, individuals from all social and financial backgrounds got here collectively to volunteer and rescue as many individuals as bodily potential from the rubble of the collapsed factories.

That form of native and international spirit of collaboration would imply that Bangladesh continues to be an exemplar of the best way to enhance well being care within the International South.

Dr. Junaid Nabi is a public well being researcher specializing in health-care reform and innovation. Beforehand a SAARC scholar in Bangladesh, he carried out analysis on international well being and supplied catastrophe administration coaching in Dhaka. He’s a senior fellow on the Aspen Institute and a Millennium Fellow on the Atlantic Council.