Bangladesh could become regional leader in cancer care with right policies, investments: Speakers

With the right policies and investments, Bangladesh has the potential to become a regional leader in cancer care. This could significantly reduce the number of patients seeking treatment abroad while building a healthcare system that offers advanced, affordable cancer care to all, said experts at a roundtable discussion.

The roundtable titled "Cancer Care Accessibility and Affordability in Bangladesh" also addressed the country's rising cancer burden, pointing out the insufficient treatment facilities, the shortage of oncologists, and the high treatment costs, which leave many patients unable to afford care and drive a significant number into poverty due to medical expenses.

The event was jointly organised by Beacon Pharmaceuticals PLC and The Business Standard ahead of World Cancer Day on 4 February.

During the discussion, healthcare professionals, cancer survivors, economists, and industry leaders emphasised key reforms that could revolutionise cancer treatment in Bangladesh.

Dr Syed Abdul Hamid, Professor at the Institute of Health Economics, Dhaka University

Bangladesh faces a high burden of cancer patients. Each year, around 300,000 new cases are diagnosed, and around 150,000 people die from the disease. Due to the lack of routine screening programmes, most patients are diagnosed at the middle or late stages – often when they start experiencing severe pain or require hospitalisation.

Cancer treatment facilities in Bangladesh are limited. The National Cancer Institute and eight medical colleges offer cancer care, including radiotherapy. Some private-sector facilities exist and are gradually expanding, but they remain insufficient compared to the growing number of patients.

Around five to seven years ago, Bangladesh had only 250 oncologists, whereas the World Health Organisation (WHO) recommends over 1,000 for the country's needs. Despite this, medical colleges have not increased postgraduate seats for oncology training, nor is there a strategic plan to address the shortage. Currently, only 5–7 new oncologists graduate each year. Five years ago, the country faced a shortfall of 750 oncologists; today, the gap has widened even further. At the current rate, it would take centuries to meet the demand.

A study we conducted four years ago found that the average cost of cancer treatment in Bangladesh is around Tk6.5 lakh. The cost varies widely, ranging from Tk3 lakh to Tk1 crore, with treatment within the country reaching up to Tk 20 lakh. Many patients cannot afford these expenses. Another study revealed that 17.5% of cancer patients fall below the poverty line due to treatment costs. In the absence of health insurance, they are forced to sell assets, take loans, or seek financial help from others.

To address this crisis, Bangladesh must increase skilled manpower in cancer treatment. The rise of cancer and other emerging diseases requires a clear estimation of the healthcare workforce needed. Based on this estimate, medical colleges should expand postgraduate seats for oncology training. Additionally, doctors and nurses should receive 6 months to 1 year of specialised training to prepare them for cancer care. Those interested in further studies should be given the opportunity to pursue FCPS, MS, or other advanced degrees in oncology.

A National Health Fund must be established with contributions from both the government and the public. With 190 million mobile users, even a Tk1 daily contribution per user could generate Tk 7,500 crore annually.

Additional funding could come from tobacco taxes, sugar-sweetened beverage taxes, pharmaceutical CSR contributions, and donor agencies, potentially raising up to Tk 20,000 crore. This fund should be used to enhance cancer care capacity and ensure that patients seek treatment within the country, reducing medical tourism.

By implementing these measures, Bangladesh's health sector – especially cancer care – could see significant improvements within the next 10–15 years.

Mahbooba Panna, Cancer survivor and former Additional Secretary

I used to get VIA and other tests done at Mohammadpur Fertility Centre every two years. But how well do people in Bangladesh recognise cancer symptoms? For example, when I noticed something unusual on my hand, I wondered, "This doesn't seem like a normal cyst. Why did I feel that way?"

We need to create awareness about recognising unfamiliar physical sensations. Even in my own family, this awareness is lacking—everyone seems to be waiting until it's too late.

Another critical issue is what to do after a cancer diagnosis. Whom should I consult? Who will perform the surgery? How can I be sure the diagnosis is accurate? These are pressing questions that need clearer answers.

After being diagnosed with cancer, I was concerned about where to have the operation and whether my diagnosis was accurate. However, I chose to trust the doctors at government hospitals. Through this journey, I have realised that if cancer treatment in the country can inspire confidence, people will not feel the need to seek treatment abroad.

Through my journey, I have realised that people have very few reliable options when it comes to cancer treatment. The trust that icddr,b has built should be replicated in at least eight divisions through government hospitals, along with well-equipped diagnostic centres.

There should be dedicated cancer windows at cancer hospitals in all divisional headquarters, so tha patients can go there for first advice and actions.
As a cancer patient, I understand that cancer treatment is expensive, but I can still try to stay mentally strong. It's a new challenge and a new learning experience for me. By managing my condition and staying positive, I am trying to raise awareness, at least within my own family.

Prof Dr Farhad Haleem Donar, Oncologist and Chairman of the governing body at Uttara Adhunik Medical College

The number of cancer patients in Bangladesh is increasing rapidly, largely due to pollution and chemical-laden food. While treatment is essential, we must also focus on prevention. Setting up screening centers in every district can help detect cancer early, and even a 3% reduction in cancer cases through awareness could significantly cut healthcare costs.

One of the biggest challenges in cancer treatment is the high cost of radiotherapy, primarily due to the expensive machines and maintenance costs. The government must introduce policies to subsidise radiotherapy machines in both public and private hospitals and remove taxes on LINAC machines and essential cancer drugs to make treatment more accessible. Currently, patients often have to wait four months for radiotherapy, forcing many to seek treatment abroad.

When I was the Project Director at the National Cancer Institute in 2006, we purchased radiotherapy machines. However, in the 19 years since, no significant investment has been made in this area. Was this done to benefit neighboring countries' businesses at the expense of our own healthcare system? The price of cancer drugs also highlights the impact of government policy – one particular drug that used to cost Tk95,000 is now available for Tk 10,000 due to tax reductions. This proves that lowering taxes on cancer drugs is crucial for making treatment more affordable.

We can learn from the development of cardiac care in Bangladesh. Twenty years ago, most people traveled abroad for heart treatment. Today, the country has well-equipped hospitals because many doctors received overseas training and returned to share their expertise. The same approach is needed for cancer treatment – invest in radiotherapy machines, send doctors abroad for advanced training, and create positions for medical physicists in government hospitals to ensure proper operation of radiotherapy equipment.

Dr A M Shamim, Founder & Managing Director, Labaid Group

The quality of cardiac and cancer treatment available in India is also offered by some of the best hospitals in Bangladesh. To improve cancer care, we need to establish public-private partnerships.
Thanks to local companies like Beacon, the cost of cancer medication has already come down. Now, it's time for all of us to come together and campaign for better cancer care in Bangladesh.

Dr Md Akter Hossain, Director and Head at the National Pharmacovigilance Centre, Director General of Drug Administration (DGDA)

We have a strong regulation to ensure the quality standards of manufactured products before they are marketed to the people of Bangladesh. The number of domestic manufacturers of cancer medicines is increasing, leading to a reduction in drug prices.

Currently, 12 local companies are producing cancer medicines. These companies are taking the initiatives to improve product quality by investing in high quality raw materials, high-tech machinery and appointing qualified experts. Under the guidance of our respected Director General, DGDA is performing well in monitoring systems on safety, quality, and efficacy of the medicinal products, which is why our medicines are being used in 157 countries worldwide.

Mohammad Ebadul Karim, Managing Director of Beacon Pharmaceuticals PLC

The country's capability in pharmaceutical innovation is steadily growing. There was a time when cancer treatment was unavailable in Bangladesh. Today, we are able to manufacture high-quality oncology drugs, including immunotherapy, making cancer treatment both affordable and accessible. By continuing to invest in research and development, Bangladesh has the potential to become a hub for cancer medicine production.

The growth of our pharmaceutical industry did not happen overnight. It is now a market worth Tk25,000-Tk30,000 crore, contributing significantly to Bangladesh's economy. By supporting local pharmaceutical innovation and reducing reliance on imports, Bangladesh can lower treatment costs while ensuring access to high-quality medicines.

When I first started producing cancer drugs, there were significant challenges, particularly with technology. To overcome this, I reached out to several high-ranking scientists from the United States and France. I also brought in an expert from Cuba, who spent nine months in Bangladesh, training local personnel and sharing valuable knowledge with us.

Prof Dr Syed Md Akram Hussain, member of the Health Sector Reform Commission

We currently do not have data on how many cancer patients go abroad for treatment each year. However, government reports indicate that many people are forced to sell their homes to bear the cost of treatment. The private sector often has higher treatment costs because there is no government support. Private hospitals do not receive tax cuts, nor do cancer centers get soft loans to ease their financial burden.

In the last 15 years, Bangladesh has faced considerable challenges, and irregularities have reached critical levels. However, the current government's priority is the improvement of cancer treatment. If we work together, we can make significant progress. Separate laws will be made for patients and healthcare providers. For example, in India, every cancer patient receives Tk 5 lakh in support. We aim to implement similar initiatives here.

We need to develop long-term, targeted strategic and policy documents on cancer care through 2040 to prevent patients from seeking treatment abroad. This should include ensuring the availability of adequate modern treatment equipment, reducing the cost of chemotherapeutic agents, enabling the government to manufacture essential chemotherapy medicines, and imposing a SIN tax on harmful substances like tobacco, adulterated foods, asbestos, and unhealthy beverages. The revenue generated from this tax should be used to create a Cancer Fund.

With strategic investments and policy reforms, Bangladesh can ensure that every cancer patient receives the best possible care right here at home. The time to act is now, and together, we can turn this vision into a reality.

Prof Dr Aliya Shahnaz, Head of the Radiotherapy Department at Dhaka Medical College

We need at least 180 radiotherapy machines to meet the demand, but currently, we have only 22. Additionally, we lack qualified medical physicists, who are a very much essential part of radiotherapy treatment, especially for ensuring the safety and effectiveness.

Dhaka Medical College Hospital (DMCH) treats patients from all over the country, many of whom arrive with no resources. As doctors, we do our best to provide treatment and often help to cover the costs by ourselves. While DMCH has qualified oncologists, it lacks radiotherapy machines at the government level. We have the knowledge and skills to provide treatment, but without the necessary equipment, we cannot do our job effectively. When a machine breaks down, it takes a long time to repair.

Currently, modern radiotherapy treatment is only available in private hospitals, making it inaccessible to poor patients. For example, at DMCH, radiotherapy costs Tk15,000, whereas in private hospitals, it can go up to Tk2.5 lakh.

Moreover, medical physicists are crucial for operating radiotherapy machines. Private hospitals have them, but government hospitals do not. To ensure proper cancer treatment in the public sector, the government must recruit qualified medical physicists and biomedical engineers. This is the reality across all cancer departments nationwide, and I am speaking on behalf of all my colleagues.

Arif Mahmud, Director of Medical Services at Evercare Hospital Bangladesh 

There are currently 1.5 million cancer patients in the country, and the number is rising rapidly. While 15 government and 9 private hospitals provide cancer treatment, most are concentrated in Dhaka, making access difficult for patients outside the capital. Decentralising cancer treatment is crucial, and the private sector must expand its services beyond Dhaka to ensure better coverage.

For the past five months, India has not been issuing visas, forcing cancer patients to seek treatment within Bangladesh. This proves that our doctors and nurses are fully capable of providing quality care. However, to strengthen cancer treatment in the country, we need both immediate and long-term plans. Identifying key challenges and addressing them systematically will be essential for ensuring accessible and effective cancer care for all.