Inside Thought

Saima's debut as regional head of the World Health Organization is a Glory of health sector and Bangladesh is proud

Publish: 07:38 PM, 31 Jan, 2024


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On February 1, Saima Wazed took on the role of Regional Director for South-East Asia at the World Health Organization (WHO). Last year, on November 1, elections were held for the position of Regional Director for South-East Asia among the 11 member states. Among these, 10 countries exercise voting rights, as Myanmar's membership is suspended, and they could not participate in the voting. Out of the 10 countries, all eight nations cast their votes in favour of Saima from Bangladesh. On January 23, during the World Health Organization's Board meeting, Saima's appointment as the Regional Director was approved. For the next five years, Saima will be responsible for overseeing the WHO's activities in the South-East Asia region.

Many intellectuals may think that she has been anointed for this position because she is the daughter of the Prime Minister. I would like to briefly address the three questions of critics. Firstly, at 52 years of age, he became the first Bangladeshi regional director in the history of this position. Saima, the first Bengali who took on the role of policy maker for the World Health Organization, not only for the World Health Organization but also for any United Nations agency. So, this is a matter of great pride.

Secondly, the acquisition of this position by Saima is undoubtedly an acknowledgment of her work. It is a recognition of her contribution. However, simultaneously, it is an achievement for Bangladesh. Nations voted to endorse her candidacy for the position in the World Health Organization. A candidate is chosen who is esteemed in her field and recognized internationally for her work. The Bangladesh government appropriately endorsed Saima for the position of Regional Director in the World Health Organization. There was no one more qualified from Bangladesh for this position than Saima.

Thirdly, those who have minimum knowledge about the World Health Organization and the United Nations system know that to be selected for such positions, one needs one's own intelligence, qualifications, and expertise. Being the Prime Minister's daughter is not a subject for consideration here. Over the past decade, Saima Wazed has been working in various fields of health for more than a considerable amount of time. However, her most significant area of work is mental health and autism. Saima has brought this sensitive health issue to the forefront both nationally and internationally. She has broken the silence and neglect of policymakers on this issue. Saima served as the Chairperson of the Bangladesh National Advisory Committee on Neurodevelopmental Disorders and Autism. She was an advisor on mental health and autism to the Director-General of the World Health Organization. In Bangladesh, she plays a crucial role in the implementation of the Neurodevelopmental Disability Protection Trust Act of 2013. Additionally, she has contributed significantly to the Mental Health Act of 2018, the National Mental Health Policy 2022, and the Mental Health Skills Curriculum 2020-2025. Saima has illuminated the path through her work, not merely as the Prime Minister's daughter but by her own efforts.

Why Saima's inauguration as WHO Regional Director is important for Bangladesh and why we should be proud of it. For Bangladesh, this achievement carries special significance for five reasons.

Firstly, in the global context, Bangladesh holds a significant position as a modern, developed, and progressive nation in this era of globalization. One notable benchmark is the presence and representation of its citizens on the international stage. Since the 1980s, Indians have systematically planned to actively engage in various international organizations, demonstrating a well-thought-out strategy. In the field of providing advanced education to the talented individuals, there has been encouragement and support. Indians have embraced a systematic plan known as "Brain Diplomacy" to ensure their participation in various international organizations, including the United Nations and global corporate giants. India has gained recognition as one of the largest democratic nations globally. The country is currently reaping the benefits of its skilled workforce. Indians hold prominent positions in nearly all international organizations, reflecting the success of their strategic approach. In the current era of globalization, institutions such as the World Bank, IMF (International Monetary Fund), and ADB (Asian Development Bank) are actively functioning under Indian leadership. As a result, India's influence has grown on the global stage. During this era of international engagement, India has effectively safeguarded its interests on various issues. However, the Father of the Nation had initiated efforts towards the creation of an independent and capable Bangladesh immediately after the attainment of independence. He had entered into agreements for scholarships with the former Soviet Union and Germany. He also sent numerous talented young doctors and lawyers to the United Kingdom for higher education. However, after August 15, 1975, investment in education comes to a halt. Bangladesh continues to lag behind, recognized globally as a country of unskilled laborers. Those engaged solely in manual labor face a difficult fate. Consequently, even after 52 years, Bangladesh lacks a presence in global policy-making. Prime Minister Sheikh Hasina, a visionary leader, is walking the path shown by the Father of the Nation. She strives to provide advanced education to the meritorious and enhance their international exposure so that they can contribute to the nation's development. A significant achievement of these efforts is the election of Saima as the Regional Director of the World Health Organization. As a result, Bangladesh's prestige will rise globally.

Secondly, in the international arena, Saima's election and responsibility will play a crucial role in ensuring Bangladesh's self-interest security. The policies and decisions on global health determined by the World Health Organization will undoubtedly be observed by Saima in the context of securing Bangladesh's interests. In many areas, Bangladesh can excel.

Thirdly, the story of achievement in Bangladesh will now spread globally: For a long time, no one in Bangladesh has been at the policy-making level in the World Health Organization. Many success stories in Bangladesh were therefore somewhat unknown. The new research of BMRC, the success of community clinics, or the achievements in specialized health services were challenging to showcase internationally. But now, the world will easily learn about these success stories of Bangladesh for health. It will bring new dimensions and inspiration to our health sector.

"Fourthly, there will be an increase in international assistance in the health sector: Bangladesh has made significant progress in the field of health. However, there is still a long way to go. The demand for allocation in the health sector in Bangladesh is much lower compared to the achievements. To make Bangladesh's overall health system globally recognized, investment is necessary. However, this investment is not possible by the government alone, and international assistance is needed for this. Taking on this responsibility, Saima will assist Bangladesh in obtaining international aid.

Fifthly, talented youth will thrive: Saima's inauguration in a policy-making position at the World Health Organization will inspire millions of youth in Bangladesh. Saima will be their inspiration. The talented youth will find courage. I believe that on the path shown by Saima, many Bangladeshi youths will illuminate the international stage in the near future.



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Inside Thought

AI enabled Precision Treatment for Chronic Metabolic Diseases

Publish: 02:01 PM, 16 Apr, 2024


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Chronic metabolic diseases, such as type 2 diabetes, prediabetes, obesity, fatty liver, and dyslipidemia, often originate as an individual's metabolism gradually breaks down. Medical research reveals the unique functioning of each person's metabolism, posing challenges for healthcare providers in understanding and customizing personalized treatments. Addressing this complexity, a digital healthcare entity utilizes cutting-edge technology and advanced medical science to deliver personalized, precise, and timely insights with easy-to-follow recommendations to address the root cause.

Through an intuitive app, the AI-enabled Precision Treatment Technology provides members and the clinical care team individualized, precise, and timely guidance across medicine, nutrition, sleep, activity, and stress.

The Precision Treatment Platform serves as a dynamic model of each individual's unique metabolism, powered by artificial intelligence (AI) built from thousands of data points collected daily via wearable sensors, clinical lab parameters, and self-reported preferences. This platform offers thousands of parameters in a single dashboard to assist health coaches and doctors in deciding quickly. Clinical trials showed that the AI-enabled Platform assist not only to reverse type 2 diabetes but also improves the condition of dyslipidemia, hypertension, obesity, fatty liver, pancreas B cell dysfunction, inflammation and mental health of the patient.  

In Bangladesh, approximately 13 million individuals are affected by Type 2 diabetes, with a prevalence rate of 12.5%, and an additional estimated 6 million patients remain undiagnosed. Chronic metabolic disease is a growing concern globally, with the worldwide prevalence of Metabolic Syndrome estimated at 20-25%. According to the Center of Disease Control and Prevention (CDC), 415 million people globally are living with type 2 diabetes, a number projected to surpass 500 million by 2040.

The AI-enabled treatment platform has impacted over 4 million lives. Noteworthy achievements include completing the world's first randomized controlled trial (RCT) for reversing chronic metabolic disease using digital twin technology. Recently published in the American Association of Clinical Endocrinology, the one-year results showed a significant reduction in HbA1c in the intervention group (2.9% reduction from 9.0 to 6.1) and a significantly higher elimination of diabetes medications (94% elimination of type 2 diabetes medications in the intervention group). The study demonstrated an average weight loss of 7.4 kg, and 64% of members witnessed a normalization of their baseline non-alcoholic fatty liver disease (NAFLD). The RCT continues into its 3rd year with sustained health outcomes.

Today, a large and growing number of people around the world are suffering from chronic metabolic diseases, including type-2 diabetes, pre-diabetes, and obesity. The Precision Treatment Platform’s innovative approach combines advanced technology, machine learning, and compassionate care to change the lives of these individuals. It empowers people to take control of their health and reverse metabolic diseases, including type-2 diabetes. The AI-enabled digital platform is delivering on its promise of happier and healthier people, offering significant cost savings to households and employer healthcare plans.

Author: Dr. Shahjada Selim, MBBS, MD (Endocrinology), MACE (USA). Currently serving as an Associate Professor in Endocrinology at Bangabandhu Sheikh Mujib Medical University Hospital, Dr. Selim specializes in Diabetes, Thyroid Disorders, Obesity, Metabolic Disorders, and Sexual Dysfunctions.  


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Inside Thought

Bangladesh’s election: Widely boycotted or widely accepted?

Publish: 08:56 PM, 09 Apr, 2024


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Bangladesh Prime Minister Sheikh Hasina is reveling in her golden era. Having already held four terms with thumping mandates, she retains the laurel of the globe’s longest-serving female head of government. Her win in January, which secured her fifth term in office, has elicited a barrage of plaudits from almost all quarters in the region. Hasina presents the rare case where both rival Asian powers China and India agree on the benefits of her place at the helm. Regional powers, irrespective of ideological and political leanings, rushed to congratulate her incoming administration. However, most eyes after the January election were fixed on the United States, given its vocal democracy promotion efforts in Bangladesh as of late. While the US State Department did say that the elections were not free or fair, US officials recognized the new government and pledged to collaborate with it going forward. With the US weight lifted, Hasina’s ship now looks to be sailing in smooth seas.

Yet, some argue, that election was widely boycotted. The two principal arguments underlying this claim are that the opposition parties boycotted the election and that Bangladeshis resoundingly rejected the poll in solidarity with the opposition’s call to boycott.

Participation or boycott?
While the major opposition Bangladesh Nationalist Party (BNP) and its allies did sit out the election, not all opposition parties followed suit. Out of forty-four registered parties, twenty-seven fielded candidates. Additionally, nearly 1,900 independent candidates threw their hats in the ring for three hundred parliamentary seats. So, while the BNP’s absence resounded, reasonable multiparty competition and voter choice still transpired across multiple constituencies.

The official voter turnout reached 41.8 percent—a lower figure than in Bangladesh’s last contested election, albeit not an unprecedented low. Some see this low turnout as one indication that the opposition’s boycott reflected popular sentiment. The opposition boycott undoubtedly dampened some voter turnout. However, low participation does not necessarily indicate a blanket public rejection of the polls owing to opposition exhortations. In the run-up to the vote, the BNP’s anti-election protests degenerated into a violent crusade. BNP loyalists were found to be complicit in torching hundreds of vehicles. The BNP called for forty-eight hours of nationwide strikes and blockades on the eve of voting day. Arsonists set fire to polling booths and a train, killing four. This prevailing climate of trepidation likely caused some voters to stay at home on election day. Expanding absentee balloting could be a solution, but barring some exceptions, average citizens cannot vote by mail. Crucially, expats, who account for 10 percent of all voters, were effectively disenfranchised.

More tellingly, in constituencies where robust, competing candidates vied for seats, voter turnout topped 60 percent, suggesting genuine electoral contests did mobilize voters. Conversely, anemic turnout in some constituencies seems to have stemmed from lack of competition, not voters boycotting the election outright in solidarity with the BNP.

Confusion persists, however, over the Election Commission’s reported voter turnout statistics. The Commission initially announced a 27 percent turnout rate at its afternoon press briefing, later announcing a 41.8 percent final turnout. The Election Commission said that the lower afternoon figure was not in real time; it did not yet reflect delayed updates from all polling centers. Since Bangladesh uses a manual paper ballot system, where votes are hand counted and tallied, there were a few hours of lag in transmitting results from rural areas. This lag could explain the gap between the afternoon number and the final announced turnout. In that case, it is not true that 14 percent of the total votes would have had to have been cast in the final hour for the final given turnout to be accurate, as some commentators have stated.

And perhaps the Election Commission is right. But with the seeds of doubt sown, the Election Commission could help resolve any lingering doubts by publishing a detailed breakdown of hourly vote counts from all polling stations. Such transparency would provide definitive clarity on the turnout question that confused some observers.

Is Bangladesh a one-party state?
As Bangladesh charts its course following another landslide election victory for the ruling Awami League (AL), some critics warn that the country is sliding toward effective one-party rule. With AL sweeping 223 seats and its loyalist independents winning 62 more—making 95 percent of elected members broadly aligned with the ruling party—they argue that no meaningful opposition exists in parliament.

But there are a couple of problems here. First, dismissing independent members of parliament simply as AL lapdogs overlooks intricacies within Bangladesh’s political landscape. All independents prevailed after intense electoral combat with AL candidates. They will enjoy unchecked freedom to wield their votes and voices in the parliament. Article 70 of Bangladesh’s constitution prohibits members of parliament from voting against their party. But as independent candidates lacking formal party affiliation, they are immune from this restriction. In this context, the AL merits praise for taking affirmative steps to foster electoral competition and pluralism, despite lacking a formidable challenger. The AL, by allowing senior party figures to compete as independents, certainly risked potential intraparty discord. Yet, it prioritized providing voters with genuine electoral alternatives and widening the diversity of voices in parliament.

Additionally, a party achieving an overwhelming parliamentary majority through an electoral process does not equate to a one-party state. In the past, the AL and the BNP have held similar supermajorities without making Bangladesh a one-party state. Similarly, India and Japan have experienced one-party dominance without losing multiparty democracy. The key question is whether the AL orchestrated this supermajority parliament or if it was an inevitable outcome given the BNP’s election boycott.

The BNP would argue the former—that there was never a level playing field and that the crackdown and mass arrest of BNP leaders after the October 28 rally precluded any chance of a fair election, deterring their participation. However, even by October 28, the BNP had already rendered itself irrelevant to the polls by refusing participation. The October 28 protest sought to obstruct an election to called by the Election Commission in mid-November. Thus, law enforcement—at that point under the Commission’s authority—used force to halt the turmoil and ensure the election proceeded. Therefore, the state’s response to the rally should not be construed as barring the BNP’s electoral participation. The disproportionate use of force merits separate evaluation, but it is better viewed through a law-and-order lens rather than an electoral one.

Accountability starts with showing up
Rather than making alarmist claims of creeping authoritarianism, observers should have asked why the primary opposition, the BNP, forfeited the field. Just as the government warrants scrutiny for proportionality of force, the BNP should be held accountable for executing its democratic duties.

As a major political party representing 170 million people, the BNP had a duty to give voice to voters in parliament. By boycotting the election over hypothetical unfairness, they severely undermined democratic processes and disregarded people’s right to meaningful electoral choice. Even if the BNP’s claims are taken at face value that elections under the AL have no precedent of being free and fair, the demand to reinstate a caretaker government still lacks foundation. Bangladesh’s supreme court ruled it unconstitutional in May 2011. Moreover, the previous caretaker system overstayed its mandate, invoked a national emergency, and imprisoned leaders across party lines.

The boycott only assisted the incumbent AL. This squandered the chance for punitive international actions and domestic resistance had the BNP participated and electoral fraud still demonstrably occurred. As such, one could conclude that the BNP pinned higher hopes on spurring a constitutional crisis amid caretaker rule than pursuing a public mandate through elections. Through this self-defeating gambit, the BNP catapulted the AL into power, even as questions linger over the ruling party’s commitment to democratic fairness.

Gautam Lahiri is the president of Press Club of India. He served as Bangladesh as an independent foreign observer of the 2024 general elections in Bangladesh.


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Inside Thought

Under the leadership of Sheikh Hasina, BMRC is at the forefront of research


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The Father of the nation Bangabandhu Sheikh Mujibur Rahman emphasized that healthcare and its improvement were crucial for the development of the country. He believed that without advancements in healthcare and its infrastructure, and without people having the right to good health, building the nation would not be possible. Therefore, Bangabandhu formulated a beautiful policy framework at that time, which was both modern and scientifically sound. Most importantly, her daughter the visionary statesperson Sheikh Hasina has been implementing those policies in the same manner as Bangabandhu initiated, based on his foundational principles.

Bangabandhu's healthcare system was not only centralized in the capital, but it also extended to districts, police stations, unions, and even village levels. What we now call community clinics was Bangabandhu's dream. At that time, Bangabandhu could not implement the community clinic. However, today, his daughter, the Honorable Prime Minister Sheikh Hasina, has successfully completed this initiative, setting a global example. Recognized by the United Nations as 'The Sheikh Hasina Initiative,' it stands unparalleled in the annals of world history, with no other individual having such a resolution named after them. 

After independence, the healthcare system was completely disorganized and inadequate. At that time, Bangabandhu elevated the status of doctors to first class. There was no higher education or research opportunity for doctors after MBBS. Bangabandhu then established the IPGMR. Today, under the leadership of Sheikh Hasina it is Bangabandhu Sheikh Mujib Medical University, holding a prominent position as an academic institution and its reputation has spread globally as well.

After the assassination of Bangabandhu in 1975, BMRC was a toothless, spineless, dormant institution. When Sheikh Hasina took charge of the state, she handed over the responsibility of BMRC to Professor Dr. Syed Modasser Ali. BMRC is today a pioneer in research under the guidance of the Philosophical Statesperson Sheikh Hasina. But we have no chance of complacency. A few days ago, Prime Minister Sheikh Hasina instructed doctors to focus on research work. She is very interested in herself. In all fields of research only doctors seem to be a little weak in this regard. Hon'ble Prime Minister is ready to do whatever is necessary for this. All we have to do is take initiatives.


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Inside Thought

Developing health systems without evidence-based information is a challenging task


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After independence, Father of the Nation Bangabandhu Sheikh Mujibur Rahman gave us this instruction that for a state to prosper economically and stand firmly on its feet, the health of its people must be safeguarded. In line with this vision, he initiated the development of Bangladesh's healthcare system, laying down a blueprint for its advancement. This vision is enshrined in the constitution of Bangladesh, emphasizing the centrality of healthcare to the well-being of its citizens. Drawing inspiration from Bangabandhu's philosophy, our esteemed leader, Sheikh Hasina, continues to steer our nation, providing constant guidance and implementing effective measures to further enhance the country's healthcare system. 

Developing the healthcare system in Bangladesh is challenging without evidence-based research. Without understanding our challenges and opportunities, progress in healthcare is hindered. Research is essential for identifying areas for improvement. We categorize this research into three parts: basic research, gathering evidence-based information for healthcare system development, and public health research. Each of these studies plays a crucial role in advancing our healthcare system.

Community Clinics became a gambling den because the BNP government never realized how much necessary it was for the country. We are delighted that today, under the leadership of visionary statesperson Sheikh Hasina, our country has revitalized these Community Clinics, reviving their programs. Now we need research. Therefore, the benchmark of Bangladesh's healthcare system will be these Community Clinics. In this case, BMRC has a vital role to play. If we can't collect research data, then we can't develop. We need to change our current health system but we need to do a thorough research on where the change is needed, why it is needed, and how it is needed. I believe that the current government under the guidance of the Philosophical Statesperson Sheikh Hasina will increase such research work. As a result, the activities of Bangladesh Medical Research Council will increase and become stronger.



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Inside Thought

Like the economy, we will also advance in research under the guidance of the Prime Minister


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The Honourable Prime Minister has provided a strategic framework for medical research. Henceforth, we can develop a five-year action plan under the guidance of the Bangladesh Medical Research Council (BMRC). It is imperative for doctors to show interest in medical research. Integration of research methodology into medical education curriculum is underway but requires reinforcement. Adequate evaluation mechanisms should be established for physicians committed to medical research. Offering research incentives to those dedicated to medical research instead of private practice is likely to attract numerous young doctors to the field. Incorporating research findings into national-level policy-making will not only incentivize researchers but also enhance systems for the utilization of research outcomes. An initiative should be launched to facilitate collaboration among researchers at all levels, both domestically and internationally. This will afford local researchers the opportunity to work alongside their international counterparts, while also allowing international researchers to recognize Bangladesh's potential in medical research.

Doctors should not only be stuck in pursuing higher degrees or promotions through research. In this regard, health policy makers should also take precedence. It is essential to ensure the participation of doctors in national and international seminars, both domestically and abroad. The more doctors participate in international seminars, the more they will be exposed to various aspects and methodologies of global research, which will stimulate their interest in research. Moreover, such seminars hold immense potential for bilateral research collaborations with researchers from different countries.

Sheikh Fazilatunnesa Mujib Eye Hospital and Training Institute, established in the name of Bangamata in Gopalganj, is the only regional research center of the Bangladesh Medical Research Council till now. I will again call to open a cell of "Bangamata National Cellular and Molecular Research Center" at our regional research center. Then, inspiration in research among the doctors of the southern-western region will be observed, and a new gateway of research will be opened in this region. Bangladesh is now globally recognized for its emerging economic power in the world economy. Under the guidance of the visionary statesperson, the Honorable Prime Minister, we will also advance in medical research. With the assistance of BMRC, we will conduct three internationally acclaimed researches from our regional research center and publish the results of the research in international standard journals. This is my commitment to the Honorable Prime Minister.


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