The interim government's Health Reform Commission has submitted a sweeping set of recommendations that could fundamentally change the way healthcare is delivered in Bangladesh. At the heart of the report is a demand that primary healthcare be constitutionally declared a fundamental right and provided free of charge to all citizens.
The report was formally handed over to Chief Adviser Dr Muhammad Yunus on Monday at the state guesthouse Jamuna. The chief adviser, in a Facebook post later that day, confirmed that immediate directives have already been issued to implement those recommendations that are ready for execution.
This commission was one of several established following the dramatic fall of the Awami League government in last year’s mass uprising, led by students and ordinary citizens. National Professor Dr AK Azad Khan chaired the twelve-member team, which worked for over five months to produce the most comprehensive health sector reform proposal in recent memory.
The commission’s membership included prominent academics, clinicians, administrators and even a student representative—an important gesture toward democratic inclusiveness.
They call for an amendment to the Constitution to declare primary healthcare a fundamental right, superseding the current Article 18 which frames public health as a mere duty of the state. The proposed Primary Healthcare Ordinance would make this right legally enforceable, guaranteeing all citizens access to essential services regardless of income or location. The commission insists that these services be provided free of charge, and that existing health laws be updated to reflect the demands of a rapidly evolving population and disease landscape.
To address the governance vacuum that has long plagued the sector, the report proposes the establishment of an independent National Health Commission, which would provide policy oversight and support to both Parliament and the executive. In addition, a new administrative body under the Ministry of Health, the Bangladesh Health Service, would be created to consolidate expertise from both the public and private sectors.
The report is equally unambiguous in its call to scrap the current BCS Health Cadre system, recommending instead the creation of a Health Public Service Commission for recruitment and career management.
On the matter of healthcare financing, the commission urges the government to enact a law mandating that at least 5% of GDP be allocated to the health sector. It also calls for tax exemptions on medicines for non-communicable diseases like cancer and diabetes and pushes for the development of specialised services—such as oncology, organ transplant, and high-risk surgery—to stem the tide of medical tourism and bring equity to advanced care.
But the commission does not stop at systems and structures. The report recommends full enforcement of the Government Servants Conduct Rules of 1979 to restrict political activities among health officials and calls for a ban on appointing party-affiliated individuals as executive heads of health institutions.
As part of the commission’s work, a nationwide opinion survey conducted by the Bangladesh Bureau of Statistics gathered responses from 8,256 adult citizens across all eight divisions.
An overwhelming 97% of respondents called for price regulation on medicines, while 96% demanded standardisation of consultation fees. Fixed pricing for diagnostic tests and surgical procedures received support from 16% and 15% of respondents, respectively.
Seventeen percent believed primary healthcare should be completely free—a figure that speaks volumes in a country where out-of-pocket expenditure remains among the highest in the world. An extraordinary 92% supported establishing rural-style primary care centres in urban areas, reinforcing the need for spatial equity in health infrastructure.
However, 72% of those surveyed advocated for the separation of clinical treatment, public health education, and disease prevention into distinct administrative branches. Meanwhile, 76% supported allowing the transfer of support staff, while 68% were opposed to antibiotics being sold without prescriptions from MBBS-qualified doctors.
A full 79% backed high taxation on unhealthy foods, beverages, and consumer goods. The appetite for health insurance is also strong, with 71% expressing interest in enrolling if systems were in place. In a clear call for greater efficiency, 67% of respondents supported merging similar services currently run by the Directorate General of Health Services and the Directorate General of Family Planning.
Receiving the report, Dr Muhammad Yunus called it a “watershed moment” and warned that further delay would be inexcusable.
“The problems in our health sector have been with us for a long time. If we can resolve these through the reforms, it will be a historic breakthrough,” he said.
Stressing that implementation must begin immediately, Yunus pointed to one of the sector’s most entrenched problems—the chronic shortage and misallocation of doctors.
“Even where we have doctors, they’re not posted where needed. This must be solved permanently,” he said.
He added: “We cannot fix this without decentralisation. We must ensure that doctors remain in their assigned posts.”