Question: From a health systems
perspective, what are the biggest gaps Bangladesh must close to manage ageing,
NCDs, infectious diseases, and universal health coverage together?
Response: Bangladesh
is currently undergoing both demographic and epidemiological transition, posing
substantial challenges to the health systems. These challenges arise from an
ageing population and its health needs, noncommunicable diseases, emerging and
re-emerging infectious diseases, and moving towards UHC while managing these
two transitions. He referred to four system gaps which needs to be addressed on
an emergency basis: healthcare financing crisis (the OOPexp. is over 70% and
the investment in health is less than1% of GDP), integrated service delivery at
PHC levels to serve both communicable and noncommunicable diseases,
recruitment, training and deployment of health workforce of all categories, and
leveraging digital platforms to improve access and reduce corruption. He
emphasised that building trust in primary health care requires every community
clinic to be reliably staffed, stocked, and connected digitally, supported by a
transparent national accreditation system.
Question: What role can the private sector
and pharmaceutical industry play in strengthening primary care access,
especially in underserved areas?
Response: The private sector and pharmaceutical industry can be powerful allies in strengthening primary care access in Bangladesh, especially in underserved rural and peri-urban areas. Private sector and pharmaceutical industry can strengthen primary care access and quality in underserved areas through:
Technology-Driven
Enhancements in Primary Care Leveraging advanced technologies
(telemedicine, EHRs, AI, drones) to overcome geographic and infrastructure
barriers. Technologies such as telemedicine,
Electronic Health Records (EHRs), Health Information Systems (HIS), Artificial
Intelligence (AI), and even novel delivery modes like medical drones can
overcome critical barriers like geographical distance, infrastructure deficits,
and resource limitations.
Public-Private
Partnerships
Engaging in balanced public-private
partnerships that support financial sustainability and equitable access. Under Public–Private Partnerships
(PPPs), the government can contract private
hospitals and clinics to deliver subsidized primary care services in remote
areas under government financing. Expand reach through telemedicine & mobile Clinics,
reducing travel barriers for rural populations. Or Private medical and nursing
colleges and hospitals can train and deploy doctors, nurses, and allied health
workers to underserved areas. Facilitating integration of specialized care with
primary care through education and technological enablement.
The pharmaceutical
industry in
Bangladesh has shown considerable growth and export capacity, yet barriers
remain that limit its full potential in improving access to essential medicines
locally. For example, enhancing supply chain management to ensure
reliable access to medicines and diagnostics and promoting medication safety
and patient education in community settings. Through improved supply chain
collaboration and knowledge sharing, pharmaceutical companies can significantly
enhance medicine availability and quality in primary care settings. By
producing and marketing medicines in generic names, can help in reducing
medicine prices; by following GMP and Code of Conduct for marketing of
pharmaceuticals, can help in rational
use of medicine. Incentives should prioritize underserved areas, not just urban
markets. However, Government must set clear standards for quality, pricing, and
accountability to avoid over-commercialization. Also, data-sharing agreements
and monitoring mechanisms are essential to align private sector efforts with
UHC goals. Invest in APC production to reduce the cost of production of
essential medicines.
Question: Are there financing or
public-private partnership models from other countries that could work in
Bangladesh?
Response: Yes, there are PPP models from other LMICs which can be adapted roadmap
for strengthening primary healthcare in Bangladesh, drawing lessons from Thailand, Singapore, and Sri
Lanka:
1. Community Health Clinics (Thailand
Model)
Mechanism: Joint ventures
between government and private operators to run community-level clinics.
Private partners invest in infrastructure and equipment, Government provides
subsidies for essential services (maternal health, vaccinations). Outcome:
Expands access in rural and peri-urban areas while keeping costs affordable.
2. Performance-Based Primary Care
Contracts (Singapore Model)
Mechanism: Private providers deliver primary care under strict
service-level agreements monitored by the government. Outcome:
Ensures quality and efficiency while reducing burden on public hospitals.
3. Mobile & Telehealth Units (Sri
Lanka Model)
Mechanism: BOT-style
concessions with private investors for mobile clinics and telemedicine
platforms. Outcome: Extends primary care to underserved rural
populations and supports medical tourism readiness.
Question:
Where are the biggest equity gaps today- geographic, gender, or economic- and
which is most urgent to address first? How?
Response: In
Bangladesh, the largest equity gaps manifest across geographic, gender, and
economic dimensions, each presenting urgent challenges with unique impacts on
health, social justice, and development outcomes. While all three equity gaps
are deeply interwoven, addressing gender-based inequities emerges as the most
urgent starting point for several reasons. Gender inequality is a root cause
that intersects with and amplifies geographic and economic disparities,
particularly impacting women’s health, social participation, and economic
empowerment. For instance:
- Gendered barriers limit women’s access to
education and economic resources, exacerbating health inequities such as
neonatal mortality disparities (Dey et al., 2024).
- Women’s exclusion from political and economic
decision-making perpetuates inequities that hinder community-wide advances
(Rajib et al., 2026).
- Targeted empowerment strategies, including
gender quotas, capacity building, and workplace inclusivity, have
demonstrated ethical and practical viability to counteract these gaps
(Hasan, 2026).
Bangladesh’s most urgent equity gap
today is gender, particularly in economic participation and employment. Women
face far higher unemployment, lower wages, and limited access to opportunities
compared to men, making gender equity the priority to address first. Tackling
this requires stronger labor policies, childcare support, and targeted skills
training. In summary, equity gaps in Bangladesh
are multifaceted and significant across geography, gender, and economics.
However, strategically prioritizing gender equity first promises the most
transformative impact due to its fundamental role in shaping economic
opportunities and access across regions.
Question: If
Bangladesh could implement just one reform to most
improve trust in primary care, what it would be?
Response: … If Bangladesh wants people to
trust primary care, the most impactful reform is to make every community clinic reliably staffed,
stocked, and digitally connected — and prove it through transparent
accreditation.
Why This Builds
Trust
- Quality assurance: Patients often distrust primary care because
of inconsistent standards, absentee staff, and poor drug availability.
Accreditation would enforce minimum service standards (staff presence,
essential medicines, diagnostics).
- Transparency: Public dashboards showing clinic performance
(availability of doctors, medicine stock, patient satisfaction) would
reassure communities.
- Continuity of care: Linking accredited clinics to digital health
records ensures patients don’t feel “lost” when referred onward.
Q: In one
sentence, what is the most important step Bangladesh should take now to become
ahealthier country by 2041?
A:Build a
resilient, people-centred, comprehensive PHC with adequate resources and
capacities.
From
panel discussion, Bengal Delta conference 2026
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