Tk 450 cr washed away
Golam Mostafa Jibon: As the government is committed to reduce the premature deaths from non-communicable diseases, the incidence and mortality rate of non-communicable diseases has been increased in the country compared to the previous period that raises question over the role of Directorate General of Health Services (DGHS).
The goal of the DGHS was to reduce the rate of such diseases and the number of premature deaths by one-third. But, the concerned department could not bring visible achievement in this regard.
In addition, it has caused of wastage at Tk 450 crore of the government fund.
According to the sources, about Tk 444.26 crore has been spent in different purposes in the last three years. But, a large portion of the money has gone to the so-called training seminars and printing activities instead of spending in the appropriate sectors.
The rest of the money has been spent in few important sectors, which did not come to help.
Non-communicable disease experts said, “Not in reality, the expenditure has only been shown on papers to wash the eyes.”
They said, though the government spends huge amount of money every year to control non-communicable diseases, it is not coming to help for the country’s people due to huge corruption, irregularities and use of the money in unimportant sectors.
In this view, they think that almost all the money has been wasted so far.
As per example, where the death rate is expected to be decreased, there the rate of premature deaths from non-communicable diseases has been increased by 10 percent. Now the rate has been increased to 67 from the previous rate 57.
The rate of high blood pressure in the age group above of 18 years was earlier 17 percent, now it has risen to 25 percent.
Even, the uncontrolled non-communicable diseases have now turned into one of the leading causes of death in the country.
As per observations, most of the people, who died from Covid-19 had co-morbidity (hypertension, diabetes, obesity, high blood pressure, heart disease and cancer) or risk of death.
It is learned that, there is an allocation of Tk 1118 crore to control the non-communicable diseases in the ongoing Operation Plan (OP) for a period from June 2017 to June 2022.
The work is now going on under the Non-Communicable Disease Control (NCDC) program of the Department of Health. From January 2017 to June 2020, the total expenditure on the project was Tk 444.28 crore.
The allocation for the revised Annual Development Program (ADP) of the NCDC program in the 2017-18 financial year was Tk 165.30 crore. 140.93 crore was spent in that financial year.
Expenditure rate is 85.25 percent. In the 2018-19 financial year, the revised ADP allocation was Tk 171.93 crore.
The cost was Tk 152.50 crore. Expenditure rate was 88.7 percent. The revised ADP allocation for the 2019-20 Fiscal Year was Tk. 208.80 crore. The expenditure was around Tk 148.2 crore, while the expenditure rate was 70.89 percent. But, nothing has been achieved according to the indicators of the operational plan.
According to a World Health Organization survey, non-communicable diseases are now main reason behind the 67 percent of total deaths in the country.
Of these, 30 percent died from heart disease, 12 percent from cancer, 10 percent from complex respiratory diseases, 3 percent from diabetes and 12 percent of other non-communicable diseases.
The incident of high blood pressure, one of the diseases of NCD, was 17 percent, which has now risen to 25 percent before the start of OP activities.
Sources said, the huge amount of money was spent only on some posters, guidelines and messages of non-communicable diseases in certain places of Dhaka city without taking steps to reduce or control the rate of high blood pressure.
On the other hand, there was a decision to set up NCD Management Model Hospital in the Upazila Health Centers. Though it was shown on papers, in reality, the activities of NCD management model are not visible anywhere except 4-5 upazilas.
The decision was supposed to be implemented in 20 upazilas and 200 community clinics by June 2020, but it was implemented only in two upazilas. But on papers, 66 upazilas and 200 community clinics have been shown as implemented.
Although, cancer was supposed to be registered in 10 medical colleges, nothing was found in reality.
In order to ensure the services of cancer patients, cancer rate and risk factors, identification of treated cancer patients in the hospital and their follow-up, a database containing specific data of cancer patients were scheduled to be set up in 10 medical college hospitals.
There is not much progress in those works either, while the Prime Minister Sheikh Hasina has approved a project to set up new cancer hospitals in every department of the country. Nothing has been done in the implementation of hospital-based cancer registry in the last three years.
The allegations were found as correct, while an investigation was conducted in Dhaka, Chattogram, Khulna, Sylhet, Mymensingh, Rajshahi and Dinajpur Medical Colleges in this regard.
Besides, different important issues like the Health Promoting School, Healthy City and National Multidisciplinary Non-Communicable Disease Control Action Plan have not yet been seen the light.
According to the NCD management model, every upazila health complex should have an NCD corner, where some full time trained nurses, SACMO have to provide non-communicable disease services.
Patients with non-communicable diseases will be registered in these NCD corners after initial screening from community clinics and union sub-health centers.
In this context, the former Director of the Department of Health (Disease Control) Professor AKM Shamshuzzaman told The Daily Industry that, the incidence of non-communicable diseases based on age and gender is more important in our country.
“There was needed a nationwide surveillance. But that was not done. If this was the case, the country would get clear information on non-communicable disease control – what should to do and how to do,” he added.
Sources said, none of these core functions have been done in NCD control. In developed countries, NCDs have been controlled following the method.
While contacted, Prof. ABM Khurshid Alam, Director General of the Department of Health said, “I don’t know the details of Major NCD’s activities.”
“But, the term of OP may be extended by one more year to 23 years to achieve the target,” he added.