Bangladesh making strides in cardiac care, but gaps remain; prevention key, say experts

The number of cardiac patients in Bangladesh is rising due to rapid urbanisation, changing lifestyles, and unhealthy diets. While advanced medical technologies and services are expanding across the country, health experts warn that significant limitations persist, and without strong prevention measures, awareness campaigns, and a cultural shift toward healthier living, tackling heart disease effectively will remain a challenge.

At a roundtable held at The Business Standard office in the capital's Eskaton today (27 September), they pointed out serious limitations in cardiac care, including a shortage of cardiologists, surgeons, nurses, and technicians, and Dhaka-centric services with poor facilities at upazila level. They also cited gaps in advanced procedures such as aortic surgery, complex valve operations, and pediatric treatment, as well as unreliable medicine supplies at NCD corners.

Sharier Khan, senior executive editor of The Business Standard, moderated the event titled "World Heart Day 2025: Don't Miss a Beat," jointly organised by TBS and United Healthcare. 

Azharul Islam Khan, director of Medical Services at the United Medical College Hospital, said, "The private sector covers about 80% of the country's healthcare. Yet, every year, around $2.5–$3 billion is spent abroad for treatment. Bangladesh now has modern medical hubs, and patients who can get service here as ambassadors for the country. However, research is lagging behind and needs more focus."

Prof Mohsin Ahmed, chief consultant, Cardiology, United Medical College Hospital, said that cardiac treatment in Bangladesh began in 1978 at the National Institute of Cardiovascular Diseases. Before that, there was no separate cardiac department. The Heart Foundation was established in 1979.

"Now, cardiac treatment is available outside Dhaka in Chattogram, Sylhet, Khulna, Jamalpur, Sirajganj, Rajshahi, and Dinajpur. However, for a population of 180 million, there are only about 1,200 cardiologists, 200 cardiac surgeons, 40 pediatric cardiologists, and 15 pediatric cardiac surgeons," he said. 

"The shortage of cardiac nurses, anesthesiologists, and technicians prevents the private sector from scaling up further. While progress has been made in coronary treatment, there are still gaps in aortic surgery, complex valve operations, and pediatric heart disease treatment. To make costly devices more accessible, government–private sector collaboration is needed," Mohsin Ahmed added.

Prof Fazila-Tun-Nesa Malik, professor and chief consultant, Cardiology, National Heart Foundation, stressed that both government and private sectors must work together to fully develop their potential. Only then can comprehensive cardiac services be ensured. 

She highlighted prevention as the most important step. Bangladesh has 446 upazilas and districts where hypertension and diabetes medicines are provided free of cost under the Non-Communicable Disease (NCD) corner. This programme has achieved remarkable progress – increasing blood pressure control from 13% to nearly 56%. However, the main challenge is ensuring an uninterrupted medicine supply.

Prof Mofassel Uddin Ahmed, consultant, Cardiac Surgery, United Medical College Hospital, said Bangladeshi doctors are not behind in skills or experience, but misinformation is pushing patients abroad. He called on media and political leaders to play a positive role.

Mohammad Rafiur Rahman, consultant, Cardiac Surgery, United Medical College Hospital, has emphasised incorporating missing elements into Bangladesh's healthcare culture. "Without quantifying problems, it becomes difficult to address them," he said.

Prof Muzaherul Huq, founder chairman, Public Health Foundation of Bangladesh, said, "Large-scale CPR training could significantly reduce deaths. Every doctor, nurse, paramedic, and even boy scouts should be trained in CPR."

Mohammad Mosaddek Hossain Biswas Dambel, president, Bangladesh Private Hospital Clinic and Diagnostic Association, pointed out that Bangladeshi doctors treated cricketer Tamim Iqbal successfully, but such achievements are not highlighted enough. Bangladesh has skilled doctors, and with PPP (public–private partnership), costs can be reduced and more patients can be served.

Mohammad Suman Sikder, consultant, Cardiac Anaesthesia & CICU, United Medical College Hospital, pointed to infrastructure shortages in upazila-level cardiac care. "Most Upazila Health Complexes lack ECG or Troponin-I testing facilities. The absence of CCUs is also a major challenge. Advanced treatment remains largely Dhaka-centric," he said.

Prof Syed Zakir Hossain, line director, NCDC Programme, Directorate General of Health Services (DGHS), said around 1.7 million patients are currently registered under Non-Communicable Diseases (NCD) corners. He highlighted that the average daily salt intake in Bangladesh is 9 grams, whereas the WHO recommends only 5 grams. Physical activity and fruit–vegetable intake are also below required levels.

He stressed that the focus should be on prevention rather than just building hospitals. Of Bangladesh's health budget, only 4.2% is spent on NCDs, with most going to curative services, while preventive services receive little allocation. Ensuring a continuous medicine supply can improve control rates further.

Abu Muhammad Zakir Hussain, chairman of Community Clinic Health Support Trust and a member of the Health Sector Reform Commission, said that primary and secondary prevention must be prioritised. He noted a lack of counselling as a major issue – there are no counsellors in government hospitals, and no training, despite its importance for lifestyle modification.

Syed Mohammed Atique, senior consultant, Cardiology, United Medical College Hospital, said that although there is great potential, Bangladesh is still at an early stage. Rapid progress is possible with digital health, app-based communication, and patient follow-up systems. Most importantly, a research and registry system must be established so that every study and policy decision is based on accurate data.