As the new BNP-led government assumes office and ministers take charge, public health experts say revitalising an almost stagnant health division will be one of its most urgent challenges.
Years of underfunding, weak governance and disrupted services have left the sector struggling to meet growing demands.
With Sardar Md Shakhawat Hossain appointed as Health and Family Welfare minister, attention is now turning to how quickly and effectively the government can translate its ambitious election pledges into practical reforms.
Experts argue that implementation, not promises, will determine whether the sector improves.
Dr Benazir Ahmed, a former Director (Disease Control) at the Directorate General of Health Services (DGHS), said restoring momentum in public healthcare must be the administration's primary focus.
"The speed we need in the government health sector was lost in recent years. Accelerating activity within the health division should be the main priority," he told The Financial Express.
He pointed to multiple structural challenges: a rise in non-communicable diseases, disruptions in medicine supply to public hospitals, chronic staff shortages and inadequate funding. Public health programmes, he said, have also lost momentum.
According to the BNP's election manifesto, households still bear 72 per cent of healthcare costs out of pocket, reflecting what it described as years of neglect, political interference and weak accountability.
The party has pledged to pursue "Health for All" and move towards universal health coverage.
Among its headline commitments is raising health expenditure to 5 per cent of GDP. In contrast, allocation in the FY2025-26 budget stands at 0.67 per cent of GDP -- well below global benchmarks.
Dr Ahmed, however, questioned the feasibility of the 5 per cent target. "We certainly need higher allocations. But there are also concerns that the ministry has struggled to utilise its existing budget efficiently.
Five per cent may not be realistic immediately. We need a clear policy framework to prioritise spending and ensure proper utilisation," he said.
He recommended a five-year strategic work plan addressing non-communicable diseases, workforce expansion, monitoring and evaluation mechanisms, and accountability structures to give substance to the manifesto commitments.
The BNP has also pledged to introduce electronic health cards, allowing doctors to access patients' treatment histories, test results and prescriptions instantly.
Supporters say this could reduce medical errors and improve continuity of care.
Dr Ahmed cautioned that digital reforms require careful planning. "We have seen various digitalisation initiatives in the past that remained largely symbolic.
There are different models internationally, some store medical records, others facilitate payments. But these must be designed with expert consultation and strong governance," he said.
The manifesto further promises to establish one primary healthcare unit in every rural union and at least one in each urban ward, alongside modern secondary healthcare units in every district.
It also commits to recruiting 100,000 health workers, 80 per cent of them women, and strengthening maternal and child healthcare.
Public-private partnerships (PPPs) are proposed for complex and high-cost treatments, including road-traffic injuries, stroke, heart failure, kidney failure and cancer.
Under a planned National Health Protection Authority, the government would purchase services from registered private hospitals through a Health Protection Fund.
Poor families could receive assistance of up to Tk 500,000, while middle-income households would benefit from subsidised rates.
Dr Ahmed stressed that PPPs must remain "people-centric". Previous experiences, including kidney dialysis programmes, have delivered mixed results. "Such arrangements must be carefully designed to ensure they genuinely serve patients rather than providers," he said.
Beyond financing and infrastructure, experts highlight operational weaknesses. Vaccine supply chains face disruptions in both logistics and manpower. Many sanctioned posts remain vacant, while inadequate monitoring and financial support hamper service delivery.
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