Hiren Pandit: The Covid-19 pandemic has disrupted the world economy and taken countless lives and upset livelihoods. The countries vulnerable to climate change like Bangladesh are adversely affected by the pandemic as well as natural disasters.
According to the Directorate General of Health Services (DGHS), there are 654 government hospitals in Bangladesh with a total of 51,318 beds. There are 5,055 private hospitals with a total capacity of 90,587 beds. Bangladesh has achieved a good deal in the health sector. This includes reducing maternal and child mortality.
The country is already moving towards universal health care or universal health coverage by providing free medical care in community clinics and government hospitals across the country and free vaccinations through national immunization programs. Apart from this, universal health coverage activities are also being carried out directly through pilot health schemes in some areas. There are also plans to launch it across the country in phases.
However, there are still challenges in universal health care in the country. Even now, marginalised and disadvantaged people, especially day labourers, transgender people, hairdressers, sweepers, blacksmiths, sex workers, fishermen, cobblers, scavengers, ethnic minorities, persons with disabilities, despite their constitutional rights, face many difficulties in accessing health care. Because of the mentality in some cases non-cooperation.
With the outbreak of Covid-19, an integrated control room was set up in the health department to speed up the overall medical system in the country. To ensure better and more effective medical care, 4,000 new doctors, 5,054 nurses, 1,200 health technologists, 1,750 health technicians, 150 cardiographs, and 1,000 health workers were appointed by the authorities concerned. 4,218 physicians were added to the hotline as volunteers to provide information and services on the Covid-19 situation. A 48-member national committee was formed under the leadership of the health minister and a 16-member expert team was formed. In addition to the 1100 ICU beds, the number of Covid-19 dedicated hospitals in the country has been increased with about 12,000 general beds. DNCC Covid Hospital, which has further accelerated the Covid-19 collaboration activities.
The prime minister has assured the people that she would provide vaccinations to them. By October 07, 2021, a total of 52.7 million people received the first dose, and 18.6 million people completed both the 1st and 2nd doses. Meanwhile, during the Covid-19 pandemic, the government has taken all measures for the people of the country in its far-reaching action plan. When many developed countries could not start vaccination activities, the vaccine came to Bangladesh through the initiative of the government.
The global coronavirus vaccine Covax has promised to provide free vaccinations to 40 per cent of the total population of Bangladesh. The alliance, led by the World Health Organization, was initially intended to provide free vaccinations to 20 per cent of the population. Now they have increased it by another 20 per cent. As per this, Bangladesh will get a total of 136 million doses of vaccine from Covax.
Universal health coverage will be implemented in our country only when people do not have to spend out-of-pocket money to get health care, they can get any kind of medical service for free only when they need it through specific plans and activities. You may have to go a long way for this. However, it is difficult to provide free healthcare to all the people in a country like ours.
Now we are in the era of SDGs. Earlier our expectation was health for all. That being said, accessible and quality health is available to all. The expectation that we speak of health for all is not yet confirmed. But now we have to rearrange the expectations due to the change of days. New diseases like Covid-19 are taking the shape of a pandemic. Now the epidemics are cancer, heart attack, and diabetes. These are the epidemics of the new era, the era of SDGs.
Now the cost of health has become much more expensive. According to government figures, 67 per cent of our health spending is out of pocket. But the global standard is about 34 per cent. We are spending almost twice as much. Health costs are a big burden for us. We do not accept the cost of healthcare properly. Not only the poor but also many middle-class families have become destitute due to lack of health care. Because now the type of disease has also changed. Many have to take medication for cancer or chronic illness. The government, of course, has some initiatives. There are large programs to distribute essential medicines. We have to think about solving this problem. The issue of access to health care for marginalized and disadvantaged people has come to the front.
There are about 14,500 community clinics in the country that provide services to marginalised people. That does not mean there is any room for complacency.
The right of people to access healthcare is not a matter of kindness or compassion, it is also a matter of broad understanding of the common man and the creation of a culture of accountability for those who are playing the role of service providers at the public-private level. Building a rights-based health infrastructure will make it easier to achieve these goals, achieve the SDGs, and, above all, better deal with Covid-19 or similar pandemics. At the same time, easy access to health care will be ensured for the marginalized people.
For all in the implementation of the SDGs, the intended SDG-3 has been used to ensure healthy living and reduce inequality in the SDG-10. The SDG-10 is the goal to reduce inequality. Thus, it can be said that no goal can be considered achieved until everyone’s needs are met. So ‘leaving no one behind’ applies to all purposes. Therefore, not leaving anyone behind means reaching out to every single person and this has been considered as one of the most pertinent features of the 2030 Agenda.
In the context of Bangladesh, disadvantaged, poor, vulnerable, and marginalised people are at risk may lag behind in SDGs. Therefore, in the year of Mujib centenary, health care for all is the highly expected and long-cherished issue. We have to give easy access to health care for all.
The UN-sponsored Sustainable Development Solutions Network (SDSN) has conferred Prime Minister Sheikh Hasina with the “SDGs Progress Award” for Bangladesh’s steady course in responding to the universal call to action to end poverty, protect the planet and ensure peace and prosperity for all recently it is a recognition of Bangladesh amid Covid-19 pandemic.
Director-General of WHO, Tedros Adhanam Gabrius praised the steps taken by Sheikh Hasina to tackle Covid-19. Coping with the COVID-19 pandemic and keeping the economy afloat at the same time is undoubtedly commendable, although the Covid-19 situation has improved in many countries in the world in terms of adaptation and sustainable economic development. Many experts around the world have taken our country as an example when talking about managing this pandemic but more to be done for promoting health services for all.
The writer is a Research Fellow, BNNRC