How the world can assist Bangladesh sustain its momentous well being progress : Goats and Soda : NPR

When folks consider Bangladesh, they typically consider poverty. It was one of many world’s poorest nations when it was created in 1971. They usually most likely 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 revenue is roughly $2,500) and is on monitor 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 research revealed 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 six% 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 nicely. Throughout my medical coaching, I spent a number of years in Bangladesh’s Dhaka district. I used to be impressed by the mix 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 employees and a community of small well being facilities. These amenities present reproductive companies for girls, they promote immunization and so they train about diet.

A breakthrough in Bangladesh

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

It sounds logical — giving a beverage fabricated from salts (particularly sodium and potassium), sugar and water to sufferers with extreme diarrhea to revive the fluids and vitamins they’ve misplaced. However in actual fact 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 generally known as the the Worldwide Centre for Diarrhoeal Illness Analysis, 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 dad and mom 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 world well being professional Thomas J. Bollyky, the Bloomberg Chair in World Well being on the Council on International Relations. The Lancet has hailed it as doubtlessly 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 position as a mannequin of well being developments within the World South — and deal with new well being challenges?

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

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

The nation can be working with a $200 million funding from the World Financial institution to enhance major well being care, reminiscent of screening for hypertension. Accepted in August 2023, this program wants continued authorities assist to construct major health-care facilities and maintain monitoring packages on monitor.

Further well being system challenges embody understaffed health-care amenities 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 nationwide medical training technique aimed toward addressing the nation’s extreme scarcity of educated health-care employees. They’re investing within the growth of curriculum, accreditations and school.

World well being organizations have a historical past of supporting international locations throughout such crucial occasions. Throughout an identical political disaster in Sri Lanka in 2022, the World Fund to Combat AIDS, Tuberculosis and Malaria accepted $989,687 in emergency funding to make sure distribution of and entry to important medicines.

It’s crucial that these teams play a significant position throughout this transition in Bangladesh. The World Well being Group, UNICEF and nongovernmental teams that concentrate on well being and growth should unite to guard the nation’s progress and maintain momentum on essential initiatives.

And they’re going to have nice assist from the folks of Bangladesh. I’ve witnessed their resilience and adaptableness. In the course of the notorious Rana Plaza constructing collapse in Savar that killed greater than a thousand garment manufacturing facility employees in 2013, I volunteered with the Worldwide Committee of the Pink Cross in Dhaka, offering primary medical care and educating preliminary catastrophe administration strategies to Bangladesh Pink Crescent Society employees members. Although it was one of many worst industrial disasters the nation had confronted, and assets had been scarce, folks 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 sort of native and world spirit of collaboration would imply that Bangladesh continues to be an exemplar of how you can enhance well being care within the World 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 world 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.