Seema Begum lives in a remote village in northern Bangladesh. She has been suffering from hypertension for many years. As she receives medicines from upazila health complex, her condition is now largely under control. However, the cost of travel and the time required to collect medicines each time had been a major barrier for her.
The government’s landmark decision to provide anti-hypertensive medicine through Community Clinics brought great relief to Seema Begum. It saved her both travel time and expenses. However, due to the irregular supply of medicines at Community Clinics, she is not able to fully benefit from this initiative.
Seema Begum’s experience reflects the daily reality of thousands of marginalised people across the country. Due to supply shortages, many are unable to collect their medicines regularly, making it difficult to control hypertension effectively nationwide.
According to the Bangladesh Bureau of Statistics (BBS) Health and Morbidity Status Survey-2025, hypertension ranks first among the country’s top ten diseases. This means a vast number of people are at risk from this silent killer, yet a significant portion of them remain outside the reach of regular healthcare services.
In this context, the most effective solution is to ensure the availability of anti-hypertensive drugs in all Community Clinics across the country. Ensuring an uninterrupted supply of medicines at people’s doorsteps will help achieve meaningful progress in disease control. However, a consistent supply for everyone at the grassroots level remains a challenge, primarily due to inadequate budget allocation.
According to a 2019 World Bank report, only 4.2 percent of Bangladesh’s health budget is allocated to controlling non-communicable diseases—far below what is required. Yet the death toll remains alarmingly high. Every year, approximately 557,200 people in Bangladesh die from non-communicable diseases, accounting for nearly 71 percent of all deaths, and 19 percent of these deaths occur prematurely.
Due to inadequate funding allocation, medicine supplies at Community Clinics and NCD corners are often disrupted, leading to frequent shortages. As a result, despite existing demand, free medicines cannot always be provided. Irregular medicine supply often discourages poor and working-class people from buying medicines, which in turn creates serious health risks for them. So, despite policy decisions, the slow pace of implementation is causing the greatest harm to rural and poor populations.
Under these circumstances, to protect public health from the grip of a silent epidemic like hypertension, it is essential to ensure adequate budget allocation for the supply of anti-hypertensive drugs in all Community Clinics and NCD corners of upazila health complexes. Increasing budget allocation and ensuring sustainable financing would allow uninterrupted, need-based medicine supply nationwide. This would encourage people at the marginal level to seek treatment.
At the same time, all relevant stakeholders-including the Ministry of Health and Family Welfare, the Directorate General of Health Services, the Community Clinic Health Support Trust, and the state-owned Essential Drugs Company Limited (EDCL)-must work together in a coordinated way.
To control hypertension, policy decisions alone are not enough; effective implementation at the field level is now the most urgent need. Ensuring uninterrupted medicine supply and availability at Community Clinics will mean many people like Seema Begum no longer have to travel long distances. Anti-hypertensive medicines will reach the doorsteps of marginalised communities, and the prevalence of hypertension and other hypertension-related non-communicable diseases will gradually decline.
*The writers are the Bangladesh Country Lead, Cardiovascular Health, Global Health Advocacy Incubator (GHAI) and the Executive Director, PROGGA (Knowledge for Progress), respectively.
