Bangladesh seriously lacks preparedness for prevention and detection of and response to significant disease outbreaks, according to a new global index.
Bangladesh’s position on the international health security index is even worse than that of African countries like Liberia, Ghana, Côte d’Ivoire, Namibia, Tanzania, Nigeria, Senegal, Zimbabwe, Sierra Leone, Kenya, Madagascar, Ethiopia and Uganda.
In South Asia, India, Myanmar, Bhutan, Pakistan and Nepal are better prepared to manage disease outbreaks, according to the index.
The significant gaps in preparedness for epidemic and pandemic of diseases have been revealed by The Global Health Security Index, the first comprehensive assessment and benchmarking of health security and related capabilities across 195 countries.
The index was released on October 24.
The average overall 2019 GHS Index score is slightly over 40 on a 0-100 scale but Bangladesh has obtained only 35 and ranked 113th among the 195 countries.
The GHS Index is a joint project of the Johns Hopkins Center for Health Security and the Nuclear Threat Initiative, with research by The Economist Intelligence Unit.
The assessment and benchmarking of the index has been prepared based on 34 indicators in six categories of prevention, detection, rapid response, health system, compliance with international norms and risk environment.
On the 100-point scale, Bangladesh has scored 27.3 in prevention, 50.9 in detection and reporting, 23.1 in rapid response, 14.7 in health system, 52.5 in compliance with international norms, and 44 in risk environment.
In prevention, Bangladesh’ overall score is 27.3 with zero in the categories of biosafety, biosecurity and use of research in the culture of responsible science.
In anti-microbial resistance, it has scored 16.7 while 93.9 in immunisation.
In detection and reporting, Bangladesh’s overall score is 50.9 with an outstanding 100 in laboratory system, but it has scored zero in data integration between human, animal and environmental health sectors.
The epidemiology workforce score is 50 while the real-time surveillance and reporting score 45.
In the area of rapid response, Bangladesh’s overall score is 23.1 with zero in the categories of exercising response plans, emergency response operation, and linking of public health and security authorities.
The emergency preparedness and response planning score is 12.5, the risk communication score 25, the access to communications infrastructure score 45 and the trade and travel restrictions score 100.
The country has scored 14.7 in health system, with zero in the areas of communications with healthcare workers during a public health emergency, infection control practices and availability of equipment, and capacity to test and approve new medical countermeasures.
The score in health capacity in clinics, hospitals and community care centres is 27.4, in healthcare access 23.6 and in medical countermeasures and personnel deployment 33.3.
In compliance with international norms, Bangladesh has scored 52.5 with zero in cross-border agreements on public and animal health emergency response.
In risk assessment, the country has secured 44 with 16.7 in infrastructure adequacy, 38.5 in public health vulnerabilities and 43 in environmental risks.
Asian country Thailand has ranked 6th in the index while South Korea 9th, Malaysia 18th, Japan 21st and Singapore 24th.
The United States has ranked first in the index, followed by the United Kingdom, the Netherlands, Australia and Canada which have found their places among the top-ranked countries.
When asked, Health Services director general Professor Abul Kalam Azad disagreed with the GHS Index findings.
‘Bangladesh’s state of health security preparedness is quite good,’ he told New Age on Saturday.
Azad said that the evaluation of the status of biosafety and biosecurity in terms of disease prevention in the index was also not right for Bangladesh.
The index has issued some guidance and said, ‘Knowing the risks is clearly not enough when risks are magnified by a rapidly changing and interconnected world.’
‘Political will is needed to protect people from the consequences of epidemics, to take action to save lives, and to build a safer and more secure world,’ it says.
It further says that the biological threats – natural, intentional, or accidental –in any country can pose risks to global health, international security, and the worldwide economy.
Because infectious diseases know no borders, all countries must prioritise and exercise the capabilities required to prevent, detect, and rapidly respond to public health emergencies, it notes.
Every country also must be transparent about its capabilities to assure neighbours that it can stop an outbreak from becoming an international catastrophe, it goes on.
Global leaders and international organisations, in turn, bear a collective responsibility for developing and maintaining robust global capability to counter infectious disease threats, it observes.
A core principle of the GHS Index is that health security is a collective responsibility, the index in its guidance points out, making a number of recommendations.
A recommendation says that the UN Secretary-General should call a heads-of-state-level summit by 2021 on biological threats, including with a focus on financing and emergency response.
National governments should commit to take actions to address health security risks, the index says in another recommendation.
The health security capacity in every country should be transparent and regularly measured, and results should be published at least once every two years, it suggests.
Besides, countries should test their health security capacities and publish after-action reviews, at least annually and the governments and donors should take into account countries’ political and security risk factors when supporting health security capacity development.
Bangladesh Health Rights Movement chairman Rashid-e-Mahbub said that new diseases were emerging and some old diseases were re-emerging with bigger threats across the globe and Bangladesh was not out of such risks.
‘But sadly, we are in complete dark about the nature of the diseases and their trends in Bangladesh,’ he said.
‘It’s a matter of regret that the way the government should take preparations is completely missing while scientists and researchers are also not looking into the matter,’ said Mahbub, also former vice-chancellor of Bangabandhu Sheikh Mujib Medical University.
He noted that Bangladesh was still providing health services in a traditional way but ‘there is no option but taking all these risks into consideration’.
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