Healthcare Resource Guide: Bangladesh

 

Bangladesh Statistics

Summary
Market Entry

Current Market Trends

Main Competitors

Current Demand

Barriers
Registration Process

Trade Events

Government Links

CS Contact

Capital: Dhaka Population: 160 Million (Approx.)
GDP*
: $1314
Currency:
Taka (BDT)
Language
: Bengali

Summary

Currently the 57th largest economy in the world, Bangladesh has made significant socio-economic improvements in recent years resulting in improved healthcare indicators such as lower mortality rates and increased life expectancy. Government reforms, growing per-capita income, increased demand, and private sector innovation and investments all make this a promising sector. Further growth will be driven by significant investments in healthcare and pharmaceutical facilities, private-public projects, and modern diagnostics.

Healthcare is a priority in Bangladesh and the country has made remarkable progress in achieving health-related Millennium Development Goals (MDGs). Over the past decade, the country has reduced child mortality, improved maternal health, and decreased the incidence rate for many serious diseases, resulting in increased life-expectancy for Bangladeshis. Bangladesh's well-organized pharmaceutical industry has substantially contributed to the country's healthcare sector with considerable manufacturing capabilities and the ability to meet most domestic demand. Currently valued at $2 billion, the healthcare sector has maintained consistent growth and attracted global attention for its low manufacturing costs and high-quality standards. Bangladeshi medicines are exported to many countries in the world and leading companies are making forays into Europe, the United States, and Australia.


Market Entry

The healthcare sector in Bangladesh is one of the country’s most technology developed sectors. Healthcare is available through both the public sector and private sectors. The Government of Bangladesh encourages foreign companies to partner with local companies for producing drugs, especially high-tech and specialized products. To enter the healthcare sector in Bangladesh, a company is required to provide the necessary application and supporting documents. For pharmaceutical companies, the applications will go to the Directorate General of Drug Administration (DGDA). Medical colleges need to partner with a medical hospital and applications will be submitted to the University Grants Commission (UGC) and the Ministry of Health and Family Welfare.

Bangladesh offers opportunities for U.S. exporters of high-end medical equipment, surgical instruments, diagnostic equipment, and services. Imported medicines and medical devices are subject to customs duties depending on types and classes. Anti-cancer drugs, vaccines, hormonal contraceptives, and others can be imported without any tax. The medical device sector is not currently strictly regulated, although a policy for doing so has been drafted and is now awaiting approval. Price is a major factor in the domestic pharmaceutical market, which consists predominantly of branded generics. Locally manufactured medicines are very affordable and well-accepted by physicians and patients.


Current Market Trends

Bangladesh has the 8th largest population in the world with more than 166 million people. A Least Developed Country (LDC), Bangladesh has made commendable progress in achieving health-related Millennium Development Goals (MDGs). Consistent economic growth, increased government expenditures for healthcare, and improved access to medical facilities are contributing to the growth of this sector.

In Bangladesh, healthcare services are organized at primary (community), secondary (district), and tertiary (universities/specialized) levels. Primary health care is given at three levels from three different types of facilities: Community Clinics for populations of six thousand, Union Health and Family Welfare Centers (UHFWC) for populations of about thirty thousand, and Upazila Health Complexes (UHC) for populations of about 300,000 – 400,000. At the district level, secondary level district hospitals with 150 – 250 beds provide secondary healthcare services. Medical college hospitals and specialized hospitals and institutes provide tertiary or specialized health services in urban areas. There are a number of modern, specialized hospitals, mostly located in urban areas, but they are insufficient to meet growing demand. Every year a significant number of patients travel overseas for advanced medical care. The hospital services market has the potential to grow to meet high domestic demand for quality care. There are initiatives from both the public and private sectors for a number of new specialty and super-specialty hospitals, with tremendous opportunities for overseas hospital chains to set up healthcare facilities.

The drivers behind market growth are:

  • A gradual demographic shift, including increased life-expectancy over the last two decades, has translated into increased health consciousness and demand for healthcare services.
  • The income base of the population has grown over the last decade. Health expenditures per capita doubled during that same period, indicating a willingness to spend more on health as disposable incomes increase.
  • The emergence of private healthcare services, such as those offered by a number of high-quality private hospitals, including Apollo Hospitals, Square Hospitals, United Hospital, and others. These hospitals have become popular due to their high-quality services and are a major factor for increased healthcare expenditures. They are replacing some regional healthcare travel (although treatment in Singapore and Malaysia remains popular, with some wealthy Bangladeshis traveling to the U.S. for services). Currently, Apollo Hospital Dhaka is the only firm with Joint Commission International (JCI) accreditation.
  • Government expenditures for healthcare have increased in absolute terms.
  • The pharmaceutical industry in Bangladesh is poised for lift-off due to significant investments in state-of-the-art pharmaceutical facilities by leading business groups such as Square, Beximco, Incepta, ACI, and Transcom. Multinational companies such as GSK, Novartis, Aventis, and Novo have established local manufacturing units and have considerable market share. The domestic market is price sensitive and generic drugs are produced and available at a very affordable price.

Main Competitors

The main competitors for Bangladesh for healthcare treatment and services are India, Singapore, Thailand, and Malaysia. Those who can afford to will also travel to the United Kingdom and the United States.

Current Demand

Through both public and private expenditures, Bangladesh spends 3.7% of GDP on healthcare, a very small amount compared to developed countries which spend 8-12% of GDP. The government contribution to health expenditure is even lower, at 1.1%. There is significant room for market expansion as the country enters lower-middle income status.

The fact that more than two-thirds of total health expenditure is out-of-pocket (privately financed) indicates that people are willing to pay for better healthcare. A few NGOs have started a health insurance component within their package of micro-credit programs. In Bangladesh, supply-side financing has historically been the backbone of health care services as a strategy to improve the access of poor households to essential health care services. There are now also some demand-side financing mechanisms, such as a maternal health voucher scheme implemented in 33 Upazilas. These programs to increase demand have been found to significantly improve access and utilization of maternal health services.

Pharmaceutical Sector:

One of the fastest growing in Bangladesh with 231 companies in this sector. Market size is about $380 million per year, 95% met by local companies 5% imported (mainly cancer drugs, vaccines for viral diseases, and hormones).

Healthcare Facilities:

There is high demand for healthcare facilities and insufficient quantity. According to the “Household Income and Expenditure Survey”, only 25% of Bangladeshi families were covered by the social safety net program in 2010, compared to a global average of almost 60%. Total beds are 92,404; this is only .6 beds per 1000 people whereas the WHO recommends 3.5 per 1000.

Barriers

Currently, there are no specific legislative controls over the importation and sale of medical devices.


Registration Process

The Ministry of Health and Family Welfare (MOHFW) is responsible for formulating national-level policy, planning, and decision-making in the provision of healthcare and education. The national-level policies, plans, and decisions are translated into actions by various implementing authorities and healthcare delivery systems across the country from national to the community level. The Ministry and its relevant regulatory bodies also have indirect control over the healthcare system of the NGOs and the private sector. The healthcare situation in the capital Dhaka may be used as a snapshot of the healthcare sector status in Bangladesh. The majority of high quality medical institutions are centered in the city of Dhaka and it acts as the hub for medical service dissemination across the country.

Any direct foreign investor in Bangladesh needs to submit a project proposal to the Board of Investment (BoI) for scrutiny before getting approval. Once registered with BoI, companies investing in hospitals and medical educations need to obtain a license from the Directorate General for Health Services (DGHS). Pharmaceutical and medical device companies in turn have to go through the Directorate General for Drug Administration (DGDA) for licensing. However, both the licenses need to be vetted by the Ministry of Health and Family Welfare, the main responsible entity for all the sub-sectors under healthcare.

For registration, the following documents have to be attached and submitted to the DGDA (for pharmaceuticals), University Grants Commission (UGC) for Medical Colleges and the Ministry of Health and Family Welfare for hospitals:

  • Hospital/medical college/pharmaceutical company’s name and address;
  • Qualification of the entrepreneur and organogram of the plant;
  • Type of the company (private or public). If it is “Limited”, then a Certificate of incorporation has to be submitted from the registrar of joint stock companies and firms;
  • Total investment amount in the sector;
  • Source of funds;
  • Total equity;
  • Annual production limits of the approved machinery for pharmaceutical companies;
  • Proof of a hospital if seeking to establish a medical college;
  • The present situation of the plant and its facilities;
  • Proof of provision of proper health care benefits to the workers;
  • Lists of manufacturing machines and quality control machines;
  • A production program;
  • List of health care employees for hospitals;
  • Description of raw materials and packaging materials for pharmaceutical companies;
  • Lists of technical personnel and doctors for hospitals;
  • Anticipated sales and income;
  • Lists of items which will be manufactured by the pharmaceutical companies;
  • For hospitals, facilities layout;
  • Overall layout of the manufacturing facility;
  • National ID of the entrepreneur;
  • Bank facilities of the entrepreneur;
  • Trade License;
  • A No Objection Certificate from the Environmental Directorate;
  • Project registration certificate from Board of Investment
  • Tax Identification Number certificate.

Trade Events

The Embassy of the United States of America supports the Department of Commerce's International Buyers' Program (IBP) by recruiting delegations on regular intervals for the IBP trade shows. The following IBP shows focus on healthcare sectors:

  • Healthcare Information and Management Systems Society:

An international event for healthcare IT Professionals and a platform for showcasing cutting-edge healthcare IT products.

A premiere event showcasing new healthcare technology.

The world’s largest exposition for clinical laboratory products and services.

In addition to these events, Bangladesh hosts several trade events on healthcare sector:

An annual International Exhibition for the South Asian Pharmaceutical Industry.

Bangladesh’s biggest exhibition for medical equipment, surgical instruments, healthcare, and hospital equipment and supplies.

Government Links:

Healthcare Procurement

Ministry of Health and Family Welfare

Directorate General of Health Services

Directorate General of Drug Administration

Directorate General of Health Economic Unit

Directorate General of Family Planning

National Institute of Population Research & Training

Central Procurement Technical Unit

Directorate for Nursing Services

Revitalization of Community-based Healthcare Initiatives in Bangladesh Project

Center for Research and Information

Government Health Plans

UN Millennium Development Goal (MDG)

Health Nutrition and Population Sector Program (HNPSP)

Improving Health and Nutrition for Hard-to-Reach Mothers and Young Children

Support to the Health Sector Development Program

Strategic Plan for Health, Population and Nutrition Sector Development Program

(HPNSDP)


U.S. Commercial Service Contact Information

Name: U.S. Trade Center
Position:
Economic and Commercial Specialist
Email:
USTC-Dhaka@state.gov
Phone
: +880-2-5566 2000


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