$5b spent abroad annually due to healthcare gaps in Bangladesh: DCCI seminar

Bangladesh loses around $5 billion every year as patients seek medical treatment abroad, mainly due to a lack of trust in the domestic healthcare system, inaccurate diagnoses and weak service management.

Malik Talha Ismail Bari, managing director and CEO of United Hospital Limited and former senior vice president of Dhaka Chamber of Commerce and Industry (DCCI), revealed the information in his keynote speech at a seminar in Dhaka today (13 December).

The seminar, titled "Building Trust in Bangladesh's Healthcare Sector: Ensuring a Strategic Framework for Quality Control", was held at the DCCI building in Motijheel.

Talha said India is the top destination for Bangladeshis' overseas treatment and around 52% of Indian medical visas are issued to Bangladeshi patients.

In 2024 alone, about 482,000 Bangladeshi patients received medical treatment in India, he said, adding that Thailand, Singapore and Malaysia follow India as preferred destinations.

The keynote paper pointed out that a lack of trust among patients and their families, doubts over proper diagnosis, sudden increases in hospital bills, fear of hidden charges, concerns over counterfeit medicines and substandard equipment push many to believe that seeking treatment abroad is a safer choice.

Experts call for specific planning, financing strategy for healthcare sector

Speakers at the seminar stressed the need for stronger public-private coordination, clear planning and a comprehensive health financing strategy.

Bangladesh's healthcare sector lags behind due to only about 1% of GDP allocation, along with weak infrastructure, limited use of new technologies, shortages of skilled professionals, high treatment costs, management inefficiencies and poor monitoring of existing policies, they said.

Dr Md Zakir Hossain, secretary general of the Bangladesh Association of Pharmaceutical Industries, noted that although Bangladesh has had a health policy since 2011, it has not been updated in the past 14 years. 

He said the sector lacks a clear, long-term and coordinated plan defining the roles of government and the private sector, district-wise hospital needs, workforce development and resource allocation.

Dr Zakir emphasised the need for a sustainable long-term health policy with clearly defined public and private roles. He pointed out that patients' out-of-pocket expenses remain very high, partly because of inadequate medicine supply in public hospitals. Ensuring regular medicine availability would significantly reduce patients' financial burden, he said.

He further noted that Bangladesh's healthcare financing is largely dependent on patients' own spending, with no effective health insurance system or strong safety net. 

To move away from this fragmented situation, he stressed the urgency of adopting a national health financing strategy and an integrated health delivery policy, clearly outlining the responsibilities of all stakeholders while also raising patient awareness about their rights and entitlements.

In his welcome remarks, DCCI President Taskeen Ahmed noted that due to the absence of an effective health insurance mechanism, individuals have to bear nearly 74% of total healthcare expenditure on their own, posing serious financial risks for low- and middle-income groups.

To ensure a sustainable healthcare system, Taskeen stressed the need for foreign investment, strengthened public-private partnerships, adoption of modern medical technologies, effective policy implementation and efficient management. He also emphasised establishing a strong health regulatory framework to ensure a health-friendly environment for people at all levels.

National Professor AK Azad Khan, president of Diabetic Association of Bangladesh, acknowledged that there have been notable achievements in Bangladesh's healthcare sector but desired quality standards have not been achieved yet. To attain the desired development, he called for stronger government involvement.

He observed that healthcare quality in Bangladesh lags behind developed countries and even neighbouring countries. Though establishing universal health care may not be feasible at present, he stressed on implementing primary healthcare.  

Along with the overall management development, decentralisation is also crucial for the betterment of the health sector, he said. 

He also highlighted the expansion of digital healthcare to improve rural access, the modernisation of medical education curricula and creating a conducive environment for medical research.

Professor Dr Syed Atiqul Haq, chief consultant at Green Life Center for Rheumatic Care and Research, emphasised that since most citizens rely on public hospitals, there is no alternative to ensuring the highest quality standards in government healthcare facilities, along with transparency and accountability at all levels.

Dr Shafiun Nahin Shimul, professor and director at Institute of Health Economics of University of Dhaka, said the negative approach made by people is the cause of reduced confidence in the healthcare sector. 

"We need to ensure behavioral change to build confidence. We have to strengthen the overall medical system. If we are able to give primary medical services to our own people, patients will not go outside for treatment. Digitalisation, technology use will increase patients' confidence.

Dr Md Mustafizur Rahman, senior scientist at Infectious Diseases Division of icddr,b, shared that icddr,b provides diarrheal care to nearly 300,000 patients annually, and its model could be replicated elsewhere. 

He also mentioned ongoing work on cancer diagnostic genomics and expressed optimism that a dengue vaccine could be available within the next two years.