Universal Health Coverage (UHC) is not a luxury; it is a basic human right. Yet, for millions of Bangladeshis, healthcare remains painfully unaffordable. This reality makes the UHC Day 2025 theme - "Unaffordable health costs? We're sick of it!" - especially relevant for our country, where illness too often means financial disaster.
Bangladesh has made impressive progress in life expectancy, maternal mortality reduction, and immunization coverage. But behind these achievements lies a harsh truth: over 65 percent of healthcare expenses are paid directly by patients from their own pockets. This is among the highest rates in South Asia and reflects the deep structural weakness of our health financing system.
For an average family, a single serious illness-cancer, heart disease, kidney failure, or complications of diabetes-can erase a lifetime of savings. Many are forced to sell land, take high-interest loans, or abandon treatment altogether. Health shocks are now one of the top drivers of poverty in Bangladesh.
Two Systems, Two Realities: The contrast between urban and rural healthcare exposes deep inequality. While city dwellers enjoy access to modern hospitals and specialists, millions in villages still face shortages of doctors, diagnostics, emergency services, and essential medicines. Government hospitals are overcrowded and underfunded, while private hospitals-though technologically advanced-often operate beyond the financial reach of ordinary citizens.
Healthcare is gradually becoming a market commodity, not a public service. Unregulated diagnostic tests, inflated medical bills, and aggressive commercial practices are eroding public trust and worsening inequality.
The Silent Epidemic of Chronic Disease: Non-communicable diseases (NCDs) such as diabetes, hypertension, heart disease, cancer, and kidney failure are rising at alarming rates. These diseases demand lifelong treatment. The monthly cost of medicines, tests, and hospital visits is unbearable for low- and middle-income families. When healthcare becomes a lifelong financial burden, UHC remains a distant promise.
For an average family, a single serious illness-cancer, heart disease,
kidney failure, or complications of diabetes-can erase a lifetime of
savings. Many are forced to sell land, take high-interest loans, or
abandon treatment altogether. Health shocks are now one of the top
drivers of poverty in Bangladesh.
Health Insurance: The absence of a nationwide, effective health insurance system remains one of Bangladesh's greatest policy failures in health protection. Small pilot programs exist, but they are insufficient to protect the population from catastrophic health expenditure. Without insurance, UHC cannot move beyond rhetoric.
Ayurveda and Preventive Care: In the debate on UHC, the Ayurveda Unani and traditional medicine system deserves serious attention. For generations, Bangladeshis have relied on herbal and traditional treatment-especially for digestive disorders, joint pain, stress, insomnia, and lifestyle-related illnesses.
When practiced responsibly and scientifically, Ayurveda emphasizes:
Prevention over cure, Low-cost natural remedies, Lifestyle regulation and Strengthening immunity and mental health.
Proper integration of Ayurveda with modern medicine could reduce dependence on expensive drugs, strengthen preventive healthcare, and cut long-term treatment costs. Unfortunately, lack of research funding, institutional support, and regulation has pushed this system to the margins of national health policy. This is a missed opportunity in the pursuit of affordable healthcare.
What Must Change Now: If Bangladesh is serious about Universal Health Coverage, several urgent steps must be taken: Introduce a national health insurance system with government subsidies for the poor, Increase the health budget from the current low level to at least 5% of GDP, Strengthen primary healthcare through community clinics, diagnostics, and trained staff, Strictly regulate the private health sector to ensure transparency and ethical practice, Formally integrate Ayurveda and traditional medicine into preventive and long-term care and Expand digital health and telemedicine to reduce rural-urban gaps and treatment costs.
From Slogan to Social Commitment: The 2025 UHC theme is not a slogan-it is a public verdict. People are tired of choosing between treatment and survival. Health-related poverty is not a natural disaster; it is the result of policy neglect and weak regulation.
Universal Health Coverage is not just a global development target-it is a moral responsibility of the state. Without affordable healthcare, economic growth becomes meaningless and social justice remains incomplete.
On this UHC Day, Bangladesh must move from promises to protection. Because people are truly sick of unaffordable health costs-and they deserve a system that heals without destroying their future.
The writer is former Executive Director of Public Health Foundation, Bangladesh
