Intern doctor’s research brings Tk17cr life-saving drug donation at RMCH

Rajshahi Medical College Hospital (RMCH) has received a historic donation of Alteplase, a critical medication for stroke and heart attack patients, valued at approximately Tk17 crore. 

The donation, comprising 2,500 vials, will allow free treatment for around 500 patients, a significant step forward in local patient care.

Alteplase is a potent drug capable of dissolving dangerous blood clots in both the brain and heart. Each course costs Tk65,000–70,000, putting it out of reach for many. With this donation, patients in Rajshahi can now access life-saving medicine free of charge.

The milestone was made possible through the international research connections and collaborations developed by an intern doctor, Shirsho Shreyan, whose academic work and global affiliations eventually facilitated the donation.

From research to impact

Dr Shreyan's journey began years earlier, guided by a focus on medical research. As part of the World Stroke Organization's Future Stroke Leaders Cohort, he conducted studies on global telestroke services, allowing neurologists from major hospitals to advise smaller facilities lacking specialists.

His research culminated in two influential papers, one published in the International Journal of Stroke and recognised as "Paper of the Month," bringing international visibility.

Through this academic engagement and his involvement with the Angels Initiative, a global stroke awareness network, connections were established with Direct Relief, a US-based non-profit that provides medicines to low-resource countries.

From idea to implementation

When Gordon Wilcock, Direct Relief's Asia Pacific director, reached out to the hospital, Dr Shreyan informed Prof Azizul Haq Azad of Medicine and Prof Parvez Amin of Neurology to explore the feasibility of the donation. 

"When I read the email about their interest in donating this costly medicine, I felt an overwhelming sense of joy, knowing that my research is not only gaining international recognition but also directly saving lives at my own institution," said Dr Shreyan.

However, even after receiving a green signal from the hospital authorities, the key challenge remaining was the time-sensitive nature of stroke treatment. Alteplase is most effective if administered within 4.5 hours of symptom onset, whereas patients in Rajshahi often take 12–24 hours to reach the hospital. 

To maximise the drug's impact, senior doctors at the RMCH decided that Alteplase could also be used for heart attack patients, where it effectively dissolves blood clots in the coronary arteries. 

After a series of meetings with Direct Relief, the approach was approved by the organisation, with the stipulation that the medication must be used before March 2026.

As Alteplase requires strict temperature control (2–8°C), coordinating its transport from abroad to Rajshahi involved an overwhelming amount of customs duties, transport costs, and ensuring continuous cold-chain monitoring. 

The hospital team, together with Direct Relief, successfully managed the challenges, ensuring that the medication arrived safely and was ready for use.

Doctors at RMCH have now begun administering the drug to suitable patients. 

The donation, the largest ever received by the hospital, is expected to save lives and set a precedent for future contributions.