At a time when the country is grappling with a rising burden of cancer and heart and kidney diseases, a major government project aimed at decentralising specialised treatment facilities beyond Dhaka remains incomplete even after seven years.
Launched in October 2019, the project is designed to establish full-fledged specialised treatment centres in eight divisional cities. The centres will add more than 3,500 hospital beds, ensure early diagnosis of these life-threatening diseases, lower patients’ treatment costs and ease dependence on treatment in Dhaka and abroad.
But despite repeated revisions, nearly 20 percent of the physical work remains incomplete, while the procurement of equipment and the creation of a new organogram -- both crucial to operationalising the facilities -- have yet to begin.
Meanwhile, the cost of the project, titled Establishment of Full-fledged Cancer, Heart and Kidney Treatment Centres in Eight Divisional Cities, has already risen by around 50 percent, while the deadline has been stretched by four years.
Project authorities have also sought a further 30 percent cost escalation under the revised proposal.
In Bangladesh, noncommunicable diseases (NCDs), including cancer and heart and kidney diseases, account for nearly 71 percent of all deaths, with almost half occurring prematurely, according to the World Health Organization.
Initially, the then Awami League government undertook a Tk 2,388 crore project to build 100-bed cancer facilities at government medical colleges in eight divisional cities, with a deadline of June 2022.
However, the selection of sites for the facilities caused a one-year delay, before the global coronavirus pandemic led to further setbacks, according to a report by the planning ministry’s Implementation Monitoring and Evaluation Division (IMED).
The project then underwent a major overhaul after the government decided to expand the cancer facilities and add treatment units for kidney and heart diseases.
Accordingly, the project was revised in March 2024, with the cost raised by 43.8 percent to Tk 3,433 crore and the deadline extended to June 2026.
But, as of April, the project’s physical progress stood at 81.43 percent and financial progress only 30.81 percent.
The pandemic, political changes, frequent changes in the project director position, delays in decision-making, design complexities, limitations in institutional capacity and coordination gaps between the Public Works Department, which is responsible for construction, and the implementing agency, the Directorate General of Health Services (DGHS), have contributed to the delay, according to the IMED.
Under the revised plan, a 15-storey building will be constructed at each hospital, with a total of 3,534 beds.
Of these, 182 beds at each facility will be allocated for cancer treatment, 156 beds for kidney care and dialysis, and 112 beds for heart disease treatment, with a few exceptions, according to the document.
The centres will be built at medical college hospitals in Chattogram, Rajshahi, Khulna, Barishal, Rangpur, Sylhet, Mymensingh and at Kuwait-Bangladesh Friendship Government Hospital in Dhaka.
The construction of the buildings was supposed to be completed by March 2025, while the procurement and installation of furniture and equipment were scheduled to be completed by May 2025.
Among the eight hospitals, Sylhet MAG Osmani Medical College Hospital recorded the highest construction progress at 97 percent, while Mymensingh Medical College Hospital had the lowest at 53 percent, with work there remaining halted after the contract with the vendor was cancelled over non-compliance.
“As a result, a significant number of patients suffering from cancer, kidney and heart diseases are still being deprived of the desired standard of specialised treatment,” reads the IMED report.
Besides, the procurement of medical equipment, furniture, computer accessories and vehicles has yet to begin, while delays in equipment procurement and manpower recruitment may further delay the opening of the facilities even after construction is completed, according to the IMED report.
Although the design and overall construction quality were found to be satisfactory in most cases, the IMED identified several technical shortcomings in construction, including non-compliance with the Bangladesh National Building Code, concerns about the quality of construction materials and weaknesses in curing and grading, which require correction.
Now, the project authorities are seeking a further 30 percent cost escalation and a two-year time extension under a revised proposal, said Towfique Hasan Firoz, who took the reins in February 2025 after the project director’s post had remained vacant for eight months. He is the fourth project director.
The proposed cost escalation is mainly driven by the appreciation of the dollar and changes in equipment requirements.
The original cost estimate was prepared when the dollar stood at around Tk 109, but the government rate later rose to Tk 123, significantly increasing procurement costs.
The revised plan also proposes replacing outdated cobalt-based radiotherapy machines with two linear accelerators (LINACs) at each centre instead of the originally planned one LINAC and one cobalt machine, further pushing up the cost.
The procurement process for equipment will begin once the revised proposal is approved.
A fresh proposal to create around 18,000 posts for doctors, nurses and other staff for the eight facilities will be submitted to the DGHS this week, after an earlier manpower proposal submitted in 2025 ran into procedural complications.
Asked whether the facilities could be made functional by 2028, Towfique said, “We are hopeful.”
