Bangladesh is grappling with a hidden health crisis that thousands endure daily but few fully understand: a rising tide of chronic respiratory diseases, particularly chronic obstructive pulmonary disease (COPD).
It is a slow-burning epidemic—insidious in onset yet devastating in scope—silently robbing breath and life from millions, while economic hardship and inadequate healthcare systems deepen the burden.
According to the latest South-East Asia chronic respiratory disease report, which draws on the Global Burden of Disease 2023 released in October, more than 160,000 Bangladeshis died of chronic respiratory diseases in 2023. The figure accounts for 15% of all deaths nationwide.
Experts warn that even these alarming numbers tell only part of the story, as many more people suffer from COPD without ever receiving diagnosis or treatment.
Studies suggest that up to 95% of COPD cases in healthcare systems similar to Bangladesh remain undiagnosed. This means millions may be living with breathlessness, chronic cough, and fatigue—often unaware that they have a life-threatening illness that worsens without care.
Home to around 171 million people, Bangladesh faces a toxic combination of risk factors: high tobacco use, polluting household fuels, congested urban air, and hazardous work environments in construction, brick kilns, and informal industries.
Air quality further compounds the crisis, with particulate matter levels nearly nine times higher than World Health Organization safety limits.
In cities like Dhaka, thick smog from vehicles, brick kilns, and industrial emissions routinely shrouds the sky. In rural households, cooking fires—the centre of domestic life—often expose families to invisible dangers, as three-quarters of homes rely on fuels such as wood and charcoal.
Indoor air pollution disproportionately affects women and children, who spend more time in enclosed spaces.
Tobacco use adds another layer of danger. Nearly one-third of Bangladeshis consume tobacco. While smoking rates among men exceed 50%, women’s tobacco use, though lower, remains a significant concern.
Smoking not only drives the development of COPD but also worsens outcomes for those already living with the disease.
The lethal combination of tobacco, polluted air, and poverty creates a perfect storm for respiratory illness in Bangladesh.
Yet the health system remains poorly equipped to respond.
Diagnostic tools essential for early detection—such as spirometers—are scarce outside specialised facilities, leaving most patients undiagnosed until they reach advanced stages of illness.
Essential medicines like inhalers are often unavailable at primary care centres or are too expensive for many patients. Meanwhile, hospital information systems rarely capture comprehensive data on respiratory diseases, slowing public health planning and targeted interventions.
Complicating the picture further is tuberculosis, which remains a major challenge. Nearly 17,500 people died of TB in 2023. A history of TB increases the risk of COPD later in life, and active TB infections can complicate COPD treatment, creating additional challenges for clinicians.
Insights from countries leading the COPD Index 2025, published by the Copenhagen Institute for Futures Studies — released today (Wednesday) — offer a clear roadmap for Bangladesh.
In Australia, Chile, and Colombia, progress began only after governments introduced dedicated national COPD strategies—something Bangladesh has yet to adopt. Their experience shows that clear targets, inter-ministerial coordination, and sustained funding for prevention can rapidly improve outcomes.
Finland and Chile demonstrate the impact of strict tobacco control through enforcement, taxes, and public campaigns. For Bangladesh, where cigarettes and bidis remain cheap and widely accessible, following this model could save thousands of lives.
The UK, Denmark, and Costa Rica highlight the importance of early diagnosis. These countries invested heavily in primary care, ensuring spirometry is available in clinics and even via telemedicine.
If Bangladesh scaled up diagnostics at the upazila level, millions could be treated years earlier.
Clean-air leaders such as Sweden, Norway, and New Zealand show that no health system can tackle COPD alone. Pollution control, clean cooking initiatives, brick kiln regulation, and renewable energy policies are just as essential as hospital care. Without solving the air pollution crisis, COPD will only worsen.
Portugal and Greece underscore another key lesson: data matters. Their strong surveillance systems enable faster intervention and better planning. Bangladesh, too, needs a national COPD registry to identify where and why the disease is rising.
Together, these global lessons point to a simple truth: Bangladesh can prevent a severe COPD crisis—but only through coordinated policy, early diagnosis, environmental action, and empowered patients. The roadmap exists; the challenge is acting on it.
Ahead of World COPD Day, WHO Director-General’s Special Envoy for Chronic Respiratory Diseases José Luis Castro told the Dhaka Tribune that tobacco use and air pollution remain Bangladesh’s major risk factors.
“Effective policies already exist—such as the WHO MPOWER framework for tobacco control and the WHO Clean Air Guidelines. Countries implementing these policies have seen reduced smoking rates, fewer emergency visits, and increased life expectancy. But these benefits are uneven: people living in highly polluted areas remain at higher risk from birth, highlighting environmental inequality,” he said.
On World COPD Day, Castro emphasised that COPD is a medical condition—not something to be hidden or stigmatised.
“Stigma prevents early diagnosis because patients, especially smokers, are often dismissed when seeking help. This delays treatment and worsens outcomes. Healthcare providers must treat COPD patients with empathy and ensure access to proper diagnostic tools such as spirometry,” he added.
“Early detection is crucial. Anyone experiencing chronic cough or breathlessness should seek medical help immediately, and health systems must strengthen primary care so that diagnosis is available at the community level. Smokers need support—not judgment—to quit,” he said.
“It kills more than 3 million people every year, yet receives far less media attention and policy priority than diseases like cancer or diabetes. Millions live with severe disability due to COPD, often unable to work or even move within their own homes. Strong media coverage can bring visibility, push policymakers to act, and stimulate investments in early detection, treatment, and new research—especially since there has been no major breakthrough in COPD treatment in nearly 50 years,” Castro noted.
He stressed that COPD is a global emergency: “The core message is this—COPD must be treated with the same urgency as other major global health threats. The world must act now.”