Healthcare sector in disarray
We are concerned about the persistent chaos in our healthcare sector. The year 2025 was particularly troubling, as per a report by this daily, with prolonged service disruptions, medicine shortages, and policy paralysis. Thousands of people were deprived of essential care as a decades-long operational arrangement was abruptly scrapped without an effective alternative in place. At a time when the country is grappling with rising disease burdens and growing healthcare needs, these disruptions have exposed serious weaknesses in planning, coordination, and governance.
Trouble began with the sudden halt of USAID funding that affected critical programmes including tuberculosis control initiatives. The situation worsened when the interim government scrapped the proposed fifth Health, Population, and Nutrition Sector Programme (HPNSP), ending a framework that had guided health, nutrition, and family planning services since 1998. While the government argued that integrating sectoral programmes into regular ones would improve coordination, the transition was poorly managed. Months passed before alternative projects were approved, leaving gaps that directly harmed service delivery.
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Reportedly, hundreds of upazila-level hospitals faced disruptions in the supply of medicines for chronic conditions such as diabetes and hypertension. Around 14,500 community clinics—serving nearly half a million people daily—experienced prolonged shortages of essential drugs after procurement stalled for almost a year. Even when funding was later allocated, bureaucratic complications again halted procurement. Moreover, dengue outbreaks overwhelmed hospitals, influenza infection rates reached a record high, and the total fertility rate rose for the first time in five decades, signalling setbacks in preventive and family planning services.
While the promotion of over 6,000 doctors was a welcome step, placing most of them in supernumerary posts without adequate infrastructure or deployment planning has limited its benefit. This again reflects the absence of efficient leadership and long-term planning, a major weakness of our health sector. Meanwhile, the recommendations of the Health Sector Reform Commission—ranging from making primary healthcare a constitutional obligation to establishing independent and decentralised health authorities—were widely recognised as pragmatic and necessary to make healthcare efficient, accountable, and accessible to all, but little visible effort has been made to translate these proposals into concrete action.
Overall, abrupt policy decisions, weak administrative capacity, and neglect of reform have left the sector in a fragile state, depriving many of much-needed care. We hope the next elected government will take it upon itself to rid the sector of these long-standing challenges, but that doesn't mean that those in charge now should abdicate their responsibility for stabilising services and laying the groundwork for meaningful reform. Together, they must ensure better budget utilisation, continuity of essential programmes, and the implementation of long-discussed reforms. Otherwise, the vision of a people-oriented healthcare system will remain a distant dream.
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