Experts warn without swift implementation, health reform proposals to remain only paperwork

Highlights

• The health commission submitted its reform proposals on 5 May
• Health experts, including commission members, wrote a letter to CA
• Without swift action, key recommendations may remain unused, they warn
• They call for establishing a Permanent Health Commission
• Also, quality health infrastructure, a universally free primary care  

Health experts, including members of the Health Sector Reform Commission, have urged Chief Adviser Prof Muhammad Yunus to begin immediate implementation of key health reforms and incorporate them into the upcoming July Charter 2025, calling it a crucial step towards long-term transformation in the sector.

In an open letter addressed to the chief adviser on Friday (1 August), they acknowledged that Bangladesh has made significant strides in healthcare over the past decades, but persistent structural weaknesses, governance gaps, and a lack of institutional formulation have repeatedly undermined our collective efforts and achievements.

The letter stated that the recommendations of the Health Reform Commission provide a strategic and timely blueprint for structural change in health governance.

These recommendations, they said, offer more than just improvements in service coverage or quality — they lay out a broader framework for institutional reform and system-level transformation.

The open letter was signed by Health Sector Reform Commission members Bangladesh Medical University Department of Clinical Oncology Chairman Dr Syed Akram Hussain, Community Clinic Health Support Trust Chairman Professor Abu Muhammad Zakir Hussain, Pothikrit Foundation Chairman Prof Dr Liaquat Ali, Clinical Neurosciences Centre Director Professor Naila Zaman Khan, and former chief physician at icddr,b Dr Azharul Islam Khan, and Alliance for Health Reforms Bangladesh Convenor and Institute of Health Economics Professor Dr Syed Abdul Hamid.

When asked about the government's steps in this regard, Professor Md Sayedur Rahman, special assistant to the chief adviser for the Ministry of Health, told TBS, "We have seen the letter from the health experts. Health reform is a continuous process. A restructuring is underway in the health sector to improve Bangladesh's healthcare system — not only based on the commission's report but beyond that as well."

"The health budget has been increased, dependency on others has been reduced, and anomalies in the manpower structure have been addressed. The production capacity of Essential Drugs Company Limited is being increased to improve service delivery. We are working to improve urban primary health care, from preparing the list of essential medicines to setting drug prices. Committees have been formed in at least five different areas. Like in every sector, reforms in the health sector are also ongoing," he added.

What do the signatories say?

The signatories stressed the importance of prompt action, warning that without timely and strategic implementation, critical policy recommendations risk being left in official documents with little real-world impact.

They called for a nationally prioritised and time-bound roadmap, and proposed that incorporating the core health reforms into the July Charter 2025 would signal a serious and future-focused commitment to structural transformation.

While acknowledging the limitations of an interim government's mandate, the letter said several actions remain within the government's administrative scope.

As a first step, they proposed taking immediate administrative and legal measures to establish a Permanent Health Commission, which would be independent, publicly accountable, and empowered to provide strategic direction for health sector reform.

In addition, they called for beginning the process of building quality-assured public health infrastructure and establishing a universally free primary health care service with a mandatory referral system in both urban and rural areas.

Furthermore, they urged forming a time-bound Steering Committee composed of Advisory Council members to oversee implementation, operating directly under the Chief Adviser's Office.

Community Clinic Health Support Trust Chairman Professor Abu Muhammad Zakir Hussain told TBS, "We cannot tell from the outside whether our Reform Commission's recommendations are being implemented. We submitted the report on 5 May, but no one knows what kind of steps are being taken in the health sector reform." 

"This report from the Health Sector Reform Commission is the product of our long-standing thoughts and experience. It involved both our hard work and government expenditure. If the government feels it needs our assistance in implementing it, we are ready to cooperate. Since the chief adviser formed this commission, we seek his intervention to ensure its implementation," he said.

Dr Syed Akram Hussain told TBS that time is an important factor. "We believe that one of the key responsibilities of this government is to improve the healthcare system. However, while the recommendations of the Consensus Commission are being implemented relatively quickly, we are not seeing similar progress in health sector reforms."

"We believe that intervention from the chief adviser is necessary for the improvement of the health sector. That is why we want the issue of health reform to be included in the July Charter," he said.

Health experts recommended that if these initiatives begin by mid-August 2025, the necessary government orders and ordinances could be issued by December, with visible progress in the first quarter of 2026.

Describing the proposal as more than an administrative matter, the authors said it would represent the fulfilment of a moral responsibility to the nation.

If initiated in August, they added, the reforms would serve as a tribute to the martyrs of the mass uprising and a bold step towards the country's future.

They concluded by expressing hope that the chief adviser would act promptly to lay the foundation for meaningful change in the country's healthcare system.