Dhaka Medical College Hospital, a cornerstone of Bangladesh’s public healthcare system, now struggles with ‘widespread’ irregularities, including a severe shortage of medicines, leaving poor and middle-class patients without the proper care they desperately need. The hospital, consistently exceeding its bed capacity, is grappling with overcrowded wards and an overwhelming patient load, severely compromising its ability to provide proper medical care. Reports from various departments highlight a grim picture: unclean environments, low-quality food, inadequate staffing, and patients often forced to lie on the floors of overcrowded corridors and wards. Hospital Director Brigadier General Asaduzzaman Khan acknowledged the increasing number of patient complaints, admitting the gravity of the situation. “We are aware of these issues and steps are being taken to address them,” he said. However, the situation seems to have worsened, with one of the most concerning issues being the chronic shortage of medicines. A patient, who chose to remain anonymous, spoke about the difficulties of getting essential drugs from the hospital’s pharmacy. “Most of the necessary medicines are unavailable here. We often have no choice but to purchase them at higher prices from pharmacies outside,” the patient said. The stark contrast between the hospital’s shortages and the full stock of nearby pharmacies has raised suspicions about the management of medicine supplies within the facility. In one instance, a woman from a rural village was seen heading to a nearby pharmacy, escorted by a man. When asked about their destination, the woman confirmed that she was going to buy medicine. However, when questioned about the man’s identity or whether he was receiving a commission for directing patients to the pharmacy, he quickly avoided answering. Brigadier General Asaduzzaman Khan, when confronted about the shortages, explained that the problem lay in the supply chain. “What can we do if the government does not supply the required medicines? There are many items we need that are simply not being supplied,” he said. In addition to the medicine shortages, some patients have reported receiving only one type of medication over a span of several days due to the lack of necessary supplies. Families have frequently had to buy medications from outside sources, adding an extra financial burden on already struggling patients. One hospital staff member pointed to budgetary constraints as the primary reason behind the shortages. “We don’t have a government supply. We can’t always provide every medicine due to budget shortfalls. To offer complete services, we need to double our budget,” the staff member explained, though they declined to provide further details on the specifics of the hospital’s current budget allocation. Allegations of Syndicate and Bribery Practices Further complicating matters are widespread allegations of bribery and corrupt practices within the hospital. Several patients have claimed that hospital staff and ward aides are demanding bribes ranging from 50 to 100 taka for basic services such as providing wheelchairs and facilitating medical tests. These practices have added to the already heavy financial burden placed on families who are seeking essential medical care. One unregistered worker, seen assisting a patient, admitted to accepting tips for his services. "We don't force anyone to give us money, but if they do, it helps with our expenses," he said. Brigadier General Asaduzzaman Khan has acknowledged the existence of such practices, stating that the hospital is actively working to address these issues.  "Both sides share the blame. We have dismissed several people based on these complaints and are working to dismantle such practices, though complete eradication has yet to be achieved.” Read: Mismanagement and overcrowding plague Dhaka Medical College Hospital Earlier this year, in February, the High Court weighed in on the pervasive influence of syndicates in the healthcare sector. The court described the syndicates as playing "games of ducks and drakes" with people’s lives, accusing them of supplying expired drugs and medical equipment for profit. The court urged all concerned parties to remain vigilant and take action to protect vulnerable patients from such exploitative practices. Struggling Medical Supply Chain Medicine supply has long been a challenge in Bangladesh's public healthcare system. A 2020 survey revealed that 72% of public hospitals face regular shortages of medicines, exacerbating the difficulties for patients who rely on these facilities for care. A number of factors contribute to these shortages, including inadequate budget allocation, limited healthcare insurance, and an overwhelming number of outpatients. The public healthcare sector has historically received less than 1% of the country’s GDP over the past 12 years, which is insufficient to meet the demands of the growing population. Without health insurance, many patients are required to pay for outpatient services, further compounding the strain on public hospitals. Despite these challenges, some efforts have been made to improve the situation. The World Bank provided critical assistance, including supplying vaccines, syringes, and medical equipment to help Bangladesh manage the COVID-19 crisis. Besides, the government heavily subsidises public healthcare, though these subsidies are often insufficient to meet the growing demands of the system. A study conducted in 2013 at Dhaka Medical College Hospital highlighted further issues in the hospital's medical supply chain. The study, which surveyed hospital shop employees, revealed that over half of the drugs were purchased through open tender, while a significant portion came through direct purchases and donations. Read more: Government renames 14 hospitals and medical colleges However, the hospital's pharmacy suffers from a lack of proper storage facilities, with no air-conditioning or refrigeration available in the store. The management has called for improvements in quality control, storage facilities and training to improve the system. Looking Ahead The situation at Dhaka Medical College Hospital paints a worrying picture of the state of public healthcare in Bangladesh. From the lack of basic medicines to the widespread practice of bribery and corruption, the hospital's problems are a microcosm of the systemic issues that plague the broader healthcare system. While efforts to improve the situation are ongoing, patients and healthcare workers alike are calling for more substantial reforms, increased funding, and greater transparency to ensure that Bangladesh’s public healthcare system can truly meet the needs of its people.

The pact between India and the United Arab Emirates (UAE) to boost bilateral merchandise trade is likely to expand the presence of Made-in-India medicines in Middle Eastern countries, chief of the central government’s pharma export arm has told News18.com. Both countries have signed a Comprehensive Economic Partnership Agreement (CEPA) with the aim of increasing bilateral merchandise trade to $100 billion by 2030. Pharmaceuticals is one of the products that has been included in the vortex of CEPA. Read: Learning from Covid, Modi govt plans big AI push for disease surveillance across India The pact, which is claimed to be the first trade agreement India has made with a major trading partner in over a decade, eases out the conditions of drug approvals in the UAE. The process of approval for any dossier filed by Indian drug makers in UAE – to sell their medicines in their market – took up to 24 months but now, it will be approved in 90 days. The new clause applies to Indian companies who have facilities approved by eight drug regulators, including those of the US FDA, European Medical Agency, UK’s MHRA, TGA-Australia and Health Canada. The reason behind India’s limited entry into the UAE market was its high consumption of patented drugs – innovative and expensive products – which are supplied by the developed countries, including the US and Europe. While India leads the globe in manufacturing of generic medicines, UAE is bracketed among the top three high priced countries, the other two being the US and Germany. It spends $343 per capita (Rs 26,068 each person, on an average) on purchasing medicines. In 2020, the data shows, the pharmaceutical market of the UAE was estimated at $3.5 billion (Rs 26,600 crore). It was further trifurcated into patented drugs, generic drugs and OTC market. However, the demand for patented drugs was highest, capturing around 68% of the total pharmaceutical market followed by 18% generic drugs and 14% OTC drugs. HOW UAE ENTRY CAN SHARPEN INDIA’S ACCESS TO OTHER KEY MARKETS The industry calls the UAE “a gateway” to several other countries, including the Gulf Cooperation Council (GCC) Iran, Iraq and Africa. The GCC consists of Bahrain, Kuwait, Oman, Qatar and Saudi Arabia. “While UAE is an unexplored and huge market for India, it’s more attractive because of the possibility of re-exports, hence a wider reach of Indian drugs in other markets,” R Uday Bhaskar, director general of Pharmaceutical Export Promotion Council (Pharmexcil), an arm under Ministry of Commerce and Industry told News18.com. It means that the UAE first imports and then exports drugs to other countries. Hence, tapping into the UAE market will give access to multiple countries. Read: Ukraine seeks Indian intervention in ending Russian offensive According to the data by Pharmexcil, the GCC countries import drugs worth $15 billion (Rs 1,14,000 crore), out of which $4.6 billion (Rs 34,900 crore) is generic drugs – the type in which India leads the globe. Presently, in the financial year 2020-21, India exported around $492 million (Rs 3,739 crore) which is just 2% of the available generic market. “There is a huge scope of market penetration by India drug-makers,” Bhaskar said.

The government has extended supply of medicines to Indonesia in its efforts to fight the COVID-19 pandemic.  The consignment of the essential COVID-19 medicines has already reached Jakarta where the Coronavirus has taken a serious toll recently.  These medicines, sent in spirit of friendship, have been provided as per the directive of Prime Minister Sheikh Hasina, said the Ministry of Foreign Affairs on Saturday.  Also read: BNP sends medicines, medical equipment to Palestine

Global trade in medical goods saw 16.3% growth in 2020, compared to 4.7% in 2019 when the Covid-19 pandemic just started unfolding, according to the World Trade Organisation (WTO). Exports of medical products – including medicines, medical equipment and personal protective equipment (PPE) – rose more than 16%, underscoring how trade has been a lifeline for access to critical goods through the pandemic, after the initial disruptions. The share of medical goods in the world merchandise trade grew from 5.3% in 2019 to 6.6% in 2020. Trade in medical goods increased significantly in 2020, with trade in PPEs growing the most – more than 47.2%. Read: WTO to start Covid-19 vaccine supply negotiations amid clash on patents Medicine represented 52% of world trade in medical goods in 2020, according to World Trade Statistical Review 2021 issued by the WTO.