Dr Ahmed Jamsheed Mohamed is the WHO Representative to Bangladesh.
As the relentless Dhaka sun bore down, Majid, a rickshaw puller, collapsed from a silent killer, high blood pressure. Within minutes, the brain stroke left him paralyzed on one side. Within months, his family sold their land to pay for treatment. His children dropped out of school. Their future disappeared with his health. Majid's story is not rare. It's a mirror reflecting the reality of millions of Bangladeshi households—revealing a national crisis we can no longer ignore: the tsunami of noncommunicable diseases (NCDs).
The Unseen Emergency: The Hidden Burden
Heart disease, stroke, diabetes, cancer, chronic respiratory conditions, and mental health disorders- collectively known as NCDs — now account for 71% of all deaths in Bangladesh, with over half of these premature. Behind each number is a family like Majid's: grieving and financially devastated. This is more than a health emergency; It is a development crisis, a social justice issue, and a threat to national resilience.
Bangladesh faces a rapidly evolving catastrophe: An estimated 3.78 crore adults use tobacco, while 96% population consumes insufficient fruits and vegetables. Salt intake is roughly double the WHO's recommended level. Rates of physical inactivity, overweight, and obesity are steadily rising. One in four adults has hypertension, yet only 1 in 10 manages to keep it under control. Diabetes affects 11%; of the population; mental health disorders impact 18%, and 12% of children suffer from mental health issues.
These burdens affect all age groups, urban and rural areas, rich and poor alike.
In a country where 69% of healthcare costs are paid out-of-pocket and public health spending is just 0.7% of GDP, NCDs can devastate families. The poorest are hit hardest—most exposed, least protected.
Majid's story reveals a harsh truth: NCDs don't just result from poverty—they worsen it. Premature death or chronic illness drains income, forces children out of school, and drives families into generational debt. Human capital erodes, Inequality grows, and this vicious cycle continues— undermining government efforts toward sustainable development across health, education, gender equity, poverty reduction, and economic growth.
We Cannot 'Treat' Our Way Out
Imagine this: supplying just one blood pressure drug, Amlodipine, to every hypertensive patient would cost BDT 2,595 crore annually — nearly 6.3% of Bangladesh Government's entire health budget. And that's only one medicine for one condition. Add diagnostics and co-morbidities, and the burden becomes unsustainable.
We cannot 'treat' our way out of this crisis. We must 'prevent' the NCDs.
The WHO estimates that up to 80% of heart disease and type 2 diabetes, and 40% of cancers, are preventable. Every dollar invested in prevention returns seven through healthier, more productive lives.
Prevention and control of NCDs is not idealism — it is economic logic and the smartest investment a country can make. And it requires more than just the Ministry of Health. It demands a whole-of-government, whole-of-society approach — from finance to education, agriculture to local government. That is what "Health in All Policies" must look like.
It offers four wins for Bangladesh:
- Better health – Less suffering, longer lives.
- Greater equity – Protecting the most vulnerable.
- Stronger economy – A healthier, more productive workforce.
- Resilient communities – Where families and communities can thrive.
From Promise to Action: Closing Bangladesh's NCD Gap
Bangladesh has made encouraging progress. The National Multisectoral Action Plan engages more than 30 ministries. Yet progress on the ground remains slow. Industry interference is strong. Political follow-through is inconsistent. We are still far from matching the urgency of the crisis. Yet we need more than plans. We need clear mandates, efficient funding, and measurable results — now.
Encouragingly, a recent meeting of over 20 Secretaries showed political commitment reaching well beyond the Ministry of Health. On 20 August 2025, over 30 Secretaries will sign a Joint Declaration on NCD prevention — a foundation for whole-of-government action. The upcoming UN High-Level Meeting on NCDs offers a rare opportunity to build on this momentum. What matters now is translating commitment into decisive, sustained action that protects lives and strengthens national resilience.
Seven Moves to Break the NCD Cycle
1. Political will at the top: Declare NCDs a national development priority—with clear mandates, dedicated funding, and cross-ministerial accountability.
2. Smart financing: Hike sin-taxes on tobacco, and sugary drinks. Use these additional funds to increase the health budget for prevention and care. Make unhealthy choices pay for healthier futures.
3. Stronger primary health care: Make early detection and integrated NCD and mental health services a standard across every upazila.
4. Educate and mobilize: Embed healthy living and mental health literacy into school curricula, and harness mass and social media to shift norms, counter harmful marketing, and promote healthier choices.
5. People-powered, healthy public policies: Work with communities to design solutions rooted in their lived realities, adopt multisectoral policies that make the healthy choice the easy choice.
6. Transparent delivery: Monitor results openly. Enforce policies strictly. Hold all actors—public and private—accountable.
7. Local knowledge, bold ideas: Invest in research, data, and homegrown innovation to drive smarter, scalable action.
This is not a call for charity. It is a call for justice — and for survival.
A Vital Partnership with WHO
The World Health Organization (WHO) has been a key partner in Bangladesh's NCD response—providing technical guidance, strengthening health systems, and supporting integration of cost-effective interventions into primary care. WHO also drives cross-sector collaboration and promotes proven "best buys" to tackle NCD risk factors, from tobacco control to urban planning.
As Bangladesh expands its NCD efforts, this partnership—grounded in evidence, equity, and urgency—remains essential. WHO continues to support policy alignment, capacity building, and equitable, evidence-based action.
The Time Is Now
Bangladesh cannot build a prosperous future on a foundation of preventable death, disability, and despair. Every day of delay costs us human lives, productivity, and national potential.
Let Majid's story be more than a tragedy. Let it be a turning point.
United, we can beat NCDs. Divided, we will bury our future in hospital bills and lost dreams.
We know the solutions.
The time to act is not tomorrow. It is now!
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