There is strong evidence that catastrophic health expenditure is not only a major barrier in accessing existing healthcare services but also pushes healthcare seekers in deeper poverty. Catastrophic health expenditure is defined as out-of-pocket spending for healthcare that exceeds a certain proportion of a household's income with the consequence that households suffer the burden of disease.
"In Bangladesh also, biggest procrastination in development is the health or medical cost. If any family member gets a heart disease or stroke or cancer (all NCDs), entire lifesavings are spent over his or her treatment. Health economists have also recognized catastrophic health expenditure as biggest cause of poverty and obstruction to development" said MP Barrister Shameem Haider Patwary.
Prevention cannot take a backseat, especially when diseases that can be prevented are overburdening our health systems, and cause over two-thirds of untimely deaths. "If we take preventive measures like making safer spaces to walk or public parks for increasing physical activity we can reduce the risk of NCDs as well as save avoidable cost on healthcare. If we invest some of the funds for health promotion, so that more people are encouraged to use parks, walkways, gymnasiums, eventually we will end up making our people healthier and reducing overall health expenditure in the country" said Barrister Patwary.
"In my constituency, there is no park. Besides the river we have a big vacant land where a park is being made from the funds given by me from my allocation. In 15 Unions (governance units), my ultimate aim is to establish 15 gymnasiums, 15 sports centres and 15 public parks. Women in the village often do not have space to walk and so certain time will be allocated only for women everyday to use the park, so that they can walk, see the nature, meditate, and exercise, comfortably" shared Patwary.
Tobacco revenue is less than economic cost of epidemic
Strong evidence shows that the tobacco industry and the deadly impact of its products cost the world's economies more than US$ 1.4 trillion annually in healthcare expenditures and lost productivity. It is not a coincidence that around 80% of the world's 1.1 billion smokers live in low- and middle-income countries, but major tobacco companies and industries are headquartered in the richer nations. No prizes for guessing that it is the low- and middle-income countries that are reeling under the severest impact of NCDs too.
Barrister Patwary agrees. "There is a mindset problem we have in top politicians that tobacco companies give high tax." More advocacy needs to be done to expose these misconceptions and recognize tobacco use as not only a threat to public health but also to nation's development and economy.
"In last parliament, Bangladesh government had passed a law, Communicable Diseases Prevention Act. When I spoke about it, I had categorically said that we not only need that law for communicable diseases but we also need a guideline, central policy, trust or dedicated statute for non-communicable diseases (NCDs). Government has taken a note of it and working on it. We also have a National Health Policy where NCDs are reflected" shared Patwary.
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