Bangladesh struggles to cope with over 1.5 lakh new cancer cases each year

Infographics: TBS

Over 1.5 lakh people are newly diagnosed with cancer in Bangladesh each year, yet a severe shortage of treatment centres, equipment and specialists continues to leave thousands without timely care.

Health experts say the country's cancer care system is under immense strain, with most patients diagnosed at an advanced stage and facing long waiting times, financial hardship and limited access to essential services.

Professor Dr Syed Md Akram Hussain, chairman of Clinical Oncology at Bangladesh Medical University and a member of the health sector reform commission, told The Business Standard that most cancer patients in Bangladesh are diagnosed at a late stage.

"Due to the lack of early screening, low public awareness and limited services outside major cities, patients often reach hospitals when the disease has already progressed, significantly reducing their chances of survival," he said.

Akram said the cost of cancer treatment places a severe financial burden on families, often forcing patients to take loans, sell land or property, or stop treatment due to lack of funds. He stressed that cancer must be treated as a national priority, not merely a hospital-level issue.

"We want the political parties to implement their commitments on cancer treatment once they come to power," he said.

Akram said the health reform commission's 28th recommendation directly focuses on cancer treatment and control. 

"The proposal includes setting up nationwide centres for early cancer detection, increasing the number of cancer specialists and radiotherapy machines, and enabling at least one pharmaceutical company to produce active pharmaceutical ingredients (API) locally. 

"It also recommends installing 16 radiotherapy machines across eight government medical colleges, reducing VAT and import duties on cancer medicines, and offering soft loans and tax and VAT incentives to encourage private investment in cancer hospitals," he said. 

The political party that forms the next government must implement the reform commission's recommendations on cancer treatment, he added. 

State of cancer treatment

The country's only fully specialised public cancer hospital, the National Institute of Cancer Research and Hospital (NICRH), has eight radiotherapy machines, but only two are currently operational. Patients wait between eight and ten months to receive radiotherapy.

An evaluation report conducted by the Planning Commission's Implementation Monitoring and Evaluation Division (IMED) found that not only radiotherapy machines but also MRI and CT scanners at the hospital remain non-functional.

The report also found that 41.35% of patients face harassment while seeking treatment at the cancer institute, while 54% reported mistreatment by staff when accessing ambulance services. Complaints have also been raised about severe medicine shortages, long-standing non-functional equipment and staff shortages, all of which have affected service quality.

A similar situation exists at the oncology department of Bangladesh Medical University (BMU), which has only one radiotherapy machine. While the facility can treat about 70 patients a day, it often receives 200 to 300 patients, resulting in waiting times of up to four months.

Although 20 to 30 infusion pumps are required to properly manage chemotherapy and saline administration, the department has only eight.

Patients also have to wait four to six months for PET-CT scans at nuclear medicine centres, which are crucial for determining the extent of cancer spread. During this time, the disease often progresses throughout the body.

According to the GLOBOCAN 2020 report, around 156,000 people are diagnosed with cancer in Bangladesh each year. The World Health Organization (WHO) recommends at least one radiotherapy machine per 10 lakh people, which would require about 200 machines nationwide. Currently, there are only 37 radiotherapy machines across public and private hospitals combined, most of which are reportedly non-functional.

Need for better use of resources

Dr AM Shamim, managing director of Labaid Group, said much of the existing cancer treatment infrastructure in Bangladesh is operating at only a quarter of its capacity or less.

"If these facilities are used in a planned and efficient manner, treatment for 70% to 80% of cancer patients could be ensured within the country," he said.

Shamim said that the government must curb irregularities in public procurement and management, prevent overpriced equipment purchases, and close avenues for corruption. 

He also stressed the need to end politically motivated appointments and instead recruit qualified and experienced professionals as directors and professors at cancer hospitals.

"The private sector must also be encouraged. If the government creates a supportive environment instead of imposing repeated licensing and administrative hurdles, private investors will be more willing to invest," he said.

Cancer control strategy needed

Professor Dr Md Habibullah Talukder Ruskin, founder and chief coordinator of Bangladesh Breast Cancer Awareness Forum, said Bangladesh still lacks an effective national cancer control strategy, action plan or programme, noting that although a five-year strategy was once developed, it was never implemented and has not been updated since 2009.

"A national cancer registry is the foundation of cancer control. Without data on cancer types, locations, gender and age patterns, no effective planning is possible. National strategies, action plans and programmes must be developed based on cancer registry data," he said.

Ruskin said that Bangladesh is a low-income country where a large portion of the population lives below the poverty line, and many more are pushed into poverty due to the high cost of cancer treatment.

"Therefore, the state must take responsibility for treating poor cancer patients. It must also take charge of cancer prevention, provide tax and duty exemptions on land and equipment imports for private hospitals and entrepreneurs, and introduce health insurance," he added.