Prime Minister’s announcement to amend the Tobacco Control Act

Professor Dr. Md. Habibe Millat, Dhaka


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Probably no other country has spoken out against tobacco. Hon'ble Prime Minister Sheikh Hasina has taken up the challenge. She has announced to make the country tobacco free by 2040. She has taken the initiative to become the Prime Minister of a country that ranks eighth in the world in tobacco cultivation. Undoubtedly, this initiative of the Hon'ble Prime Minister to build a healthy nation is encouraging and inspiring for us. With her announcement, anti-tobacco activities in the country have gained momentum, the results of which have already begun to be seen.

In addition to success, some challenges have been created that will stand in the way of tobacco cessation. Since anti-tobacco activities are centered on the Tobacco Control Act, many initiatives are being hampered by inconsistencies in existing laws. In that case, in order to build a tobacco-free Bangladesh within the time announced by the Hon'ble Prime Minister, it is time to review some aspects of the existing Tobacco Control Act. That is why it is necessary to amend the law in this regard.

Bangladesh is one of the first countries to sign the World Health Organization Framework Convention on Tobacco Control (FCTC). After signing the FCTC, the present government amended the law in 2013 by removing various flaws in the old tobacco control law. Then in 2015 the rules of the Tobacco Control Act were passed. With the foresight of the Hon'ble Prime Minister, the FTCT has been included in the Seventh Five-Year Plan to meet the health targets of the SDGs. In continuation of which it has been possible to integrate tobacco control activities with the mainstream development. The result is like cheering. Compared to 2009, the number of tobacco users has decreased by 18.5 percent by 2016. On the other hand, the number of smokers has increased over the same period.

'Achieving Sustainable Development Goals' held in Dhaka on 30-31 January 2017; at the closing ceremony of the South Asian Speakers' Summit, the Prime Minister announced that the country would be completely tobacco free by 2040. In that announcement, he emphasized three things as a plan. The first is the adoption of a nationwide national tobacco control program. The second step is to take steps to adopt a strong tobacco tariff policy. And lastly, to take all necessary steps to implement the Tobacco Control Act and to bring the laws in line with the SDG implementation priorities and to bring the laws in line with the FCTC.

We last amended the Tobacco Control Act in 2013. The World Health Organization advised that the law be reviewed every five years. We have already passed that time. Over time, there have been some new inconsistencies in existing laws. Especially smoking on public transport; Smoking on sidewalks and restaurants; Exhibition of tobacco products at the point of sale; Selling cigarette butts; Etc. It is time to review the issues. Otherwise, the government's anti-tobacco programs will fail to yield promising results. Therefore, it is important to take initiative to amend the law in a short time.

In her speech, the Prime Minister mentioned the need to harmonize the FCTC in amending the law. Other anti-tobacco organizations, including the World Health Organization, have made six proposals to amend existing laws, all in the light of the FCTC. Our 152 Hon'ble Members of Parliament have made recommendations in this regard. We believe that if all these amendments are included, Bangladesh will go a long way towards becoming tobacco free. These proposals are, 1. Ensuring a 100% smoke-free environment by banning smoking in all public places, workplaces and public transport, including the abolition of designated places for smoking; 2. Prohibit the display of tobacco products at the place of sale; 3. A complete ban on the social responsibility program or CSR of tobacco companies; 4. Stop selling retail cigarettes or bidis; 5. Prohibit the import and sale of products such as C-Cigarettes and Heated Tobacco Products (HTP). Strict restrictions on the packaging of tobacco products, including increasing the size of illustrated health warnings.

Why did the Prime Minister announce the elimination of tobacco? Why did the promotion and spread of anti-tobacco activities increase in the country? The main reason for this is the damage caused by tobacco. According to the Global Adult Tobacco Survey (GATS) 2016, 35.3% of people aged 15 and over use some form of tobacco. Males constitute 46% of the population and females 25.2%. 16% of adults smoke. 20.6% of people use smokeless tobacco. 7.9% of minors (13-15 years old) use some form of tobacco. Tobacco is a deadly product. In Bangladesh, 8% of the deaths per year are due to non-communicable diseases such as stroke, heart attack, cancer, diabetic, kidney disease etc. And the main cause of these non-communicable diseases is tobacco. According to the World Health Organization's 'Tobacco: Key Fact' 2016, smokers have a 57% higher risk of lung cancer and a 109% higher risk of tobacco-related cancer. According to a study by the US Department of Health and Human Services, in 2016, about 126,000 people died in Bangladesh due to tobacco; Which is 13.5% of the total deMore than 61,000 children are suffering from tobacco-related diseases due to secondhand smoke. Economic losses due to tobacco-related diseases and deaths are 1.4% of national GDP. According to the data of 2016, the amount in terms of money is 30 thousand 560 crore.

As the elected representatives of the people, we are working to ensure the health of all citizens. ‘Bangladesh Parliamentary Forum for Health and Wellbeing’ formed to ensure universal health care; The Parliamentary Forum is working on the implementation of Tobacco Free Bangladesh. Following this, a letter signed by 152 members of Parliament demanding amendment of the existing Tobacco Control Act has already been handed over to the Hon'ble Minister of Health on behalf of the Forum. The Health Minister applauded the initiative of so many members of the National Assembly, irrespective of their party affiliation. He assured that he would stand by and assist in all necessary initiatives to amend the existing tobacco control laws. We believe, this initiative of ours; Contribute to ensuring the health of millions of people. The Prime Minister's announcement will be helpful in implementation.

Author: Professor Dr. Md. Habibe Millat, MP, Founding Chairman, Health Protection Foundation.


Why do Bangladeshi patients go abroad?

Dr. Mahfuz Parvez,
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According to the World Health Organization, six things need to be ensured for a health system to function properly—adequate financing, manpower, medical equipment, data, proper guidelines for service delivery and proper management. In the absence of any one of them, the other cannot function properly.

Everyone knows how little the above conditions exist in Bangladesh. Due to which common people are often victims of lack of treatment and wrong treatment. And a significant number of patients go abroad for better treatment.

While discussing these matters, it may be recalled that on September 10, 1794, a municipal sanitary code similar to that of England was introduced in Calcutta. That was the first institutional initiative in the health sector of Bengal. Almost two hundred years have passed since then. And we are still reeling in the absence of a sustainable health and medical system. I could not build a standard structure in the field of general treatment. In special emergency situations like dengue or corona, it becomes fatal. Advanced treatment is far away, with dying patients being rushed from one hospital to another in the hope of being accommodated.

In the overall situation, it has become a reality that a large part of the patients in Bangladesh go abroad for treatment. For the vast majority of Bangladeshi general patients, treatment abroad means Kolkata. Next destination is Chennai. Some flock to hospitals in Delhi or Mumbai. Many go as far as Kerala in search of more advanced medical facilities.

High class patients prefer to go to Thailand, Singapore and Malaysia. Those who can afford it, move to more developed countries.

But the question is, if you go abroad, can you always get good treatment? Many lost their lives and money due to wrong treatment and medical mafia. Patients run from one doctor to another doctor, from one hospital to another hospital inside and outside the country for cure, relief of suffering. Desperate people turn to alternative medicine or alternative medicine such as Jhar-phuk, Kaviraji. Patients with terminal illnesses are expected to seek specialized treatment after a cancer diagnosis. Because, advanced (high-end) medical services are still insufficient in our country. What has been developed is very expensive.

Therefore, patients of our country often have to go abroad to receive advanced medical treatment. India, Singapore, Thailand and Malaysia are first in the list of foreign countries. Developed countries like the United States and the United Kingdom are also on the list of the super rich. The neighboring country India is the biggest destination for Bangladeshi patients going abroad. Apart from high quality medical facilities, this is due to India's land connectivity with Bangladesh. It takes less time to travel from the northern part of Bangladesh to Dhaka than it takes to travel to India. People of India and Bangladesh have many similarities in food, language and culture. As per an average of one year, 2 lakh 21 thousand 751 patients from Bangladesh went to India for treatment. They have spent approximately five thousand crore takas. The flow of Bangladeshi patients to India is increasing every year. This is due to people's lack of confidence in the country's medical services, anarchic conditions, low quality services and high costs.

Bangladeshi patients visit India for complex heart surgery, cancer treatment, organ transplant, infertility treatment, bone and joint surgery, neurology, kidney disease, medical checkup etc. In these cases, there is a danger if the right doctor and the right hospital are not determined. For this, it is necessary to take initiative by knowing the correct information.

Bangladesh is undoubtedly a huge market for India's medical system. Despite earning hundreds of crores of rupees from this market, Indian hospitals are not paying proper attention to the patients and market of Bangladesh. Bangladeshi patients are not being helped properly in terms of providing real information and transparency. Big corporate hospitals are doing unilateral business but they are not thinking of developing a marketing system and increasing information services in Bangladesh for Bangladeshi patients.

In order to do business stably in the long term, Indian hospitals need to focus more on Bangladesh and take various practical and effective steps.

[Dr. Mahfuz Parvez, Professor, Department of Political Science, Chattogram University; Associate Editor,; Executive Director, Chittagong Center for Regional Studies, Bangladesh (CCRSBD)]


Bangabandhu – an eternal beacon of development and progress

Dr. Matiur Rahman
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Bangabandhu Sheikh Mujibur Rahman played a leading role in Bangladesh's independence struggle from Pakistan. He was a charismatic leader and served as the President of Bangladesh after independence in 1971. His leadership and foresight were instrumental in the formation of the newly independent country.

On the terrible morning of August 15, 1975, a group of army officers launched a coup against the government of Bangabandhu Sheikh Mujibur Rahman. The gang, led by wayward army officers, attacked his residence in Dhaka. As a result of the coup, most of the family members including Bangabandhu, his wife, sons Sheikh Kamal and Sheikh Jamal, child Sheikh Russel, relatives and government officials were brutally killed.

After the assassination of Bangabandhu, a military government took control of Bangladesh and the country experienced years of political instability. The new regime followed a different political agenda, which changed the political landscape of the country.

Bangabandhu Sheikh Mujibur Rahman formally declared the independence of Bangladesh from Pakistan on March 26, 1971 in response to years of political, economic, social, and linguistic and cultural rule, exploitation, oppression, and marginalization of the people of the then East Pakistan (now Bangladesh) under the ruling class of West Pakistan. .

This declaration marked the beginning of the Bangladesh War of Independence, which was organized as a nine-month armed conflict between the liberation-seeking common people of Bangladesh and the Pakistani military. The war ended with the victory of the Bangladesh Liberation Army on December 16, 1971, thereby establishing Bangladesh as an independent and sovereign nation.

Bangabandhu Sheikh Mujibur Rahman contributed significantly to nation building in Bangladesh as an independent nation. His leadership and vision laid the foundation for the country's development and progress.

As the founding leader of Bangladesh, Bangabandhu played a leading role in guiding the nation during its formation. His leadership provided stability and direction to a country that had just emerged from a long and arduous struggle for independence.

After Bangladesh's war of independence, the country faced massive infrastructure destruction and a humanitarian crisis. Bangabandhu focused on reconstruction and rehabilitation efforts, rebuilding the war-torn country and helping millions of displaced and affected citizens.

Under his leadership, the first constitution of independent, sovereign Bangladesh was adopted in 1972, providing a framework for governance and democratic principles. The constitution reflects the ideals of Bengali nationalism, democracy, secularism and socialism, reflecting Bangabandhu's humanitarian vision for a progressive and inclusive nation.

Bangabandhu emphasized the importance of social justice and economic justice. He advocated policies to uplift the marginalized and disadvantaged sections of society with a view to a more equitable distribution of wealth and opportunities.

Bangabandhu's government initiated agrarian reforms to address the problems of land ownership and landlessness. The reforms sought to provide land to landless peasants, promote agricultural development and eradicate rural poverty.

Under Bangabandhu's leadership, the government nationalized several key industries and institutions to ensure state control over strategic sectors of the economy and increase economic self-reliance.

He was vocal in favor of women's rights and empowerment. His government took steps to improve women's participation in education, the workforce, and politics. He tried to promote gender equality in various spheres of society.

Bangabandhu's foreign policy focused on establishing good relations with other countries and promoting regional cooperation. He actively participated in the Non-Aligned Movement and sought international diplomatic recognition and support for Bangladesh.

Bangabandhu laid emphasis on national unity and preservation of Bengali culture, language and heritage. He wanted to build a strong national identity and pride among the people of Bangladesh.

Bangabandhu was a strong proponent of world peace and disarmament. He called for an end to the arms race and nuclear proliferation, advocating for a world free from the threat of war.

Bangabandhu Sheikh Mujibur Rahman's dream of building a "Sonar Bangla" was a prosperous, self-reliant and just Bangladesh. He expressed this vision during his leadership and wanted to transform the newly independent country into an ideal society where people could live with dignity, freedom and prosperity.

Bangabandhu emphasized economic development as the basis of his vision to build a “Sonar Bangla”. He envisioned an economy that would be self-sufficient and able to meet the basic needs of citizens. He believed in reducing poverty and income inequality, promoting industrialization and developing the agricultural sector to ensure food security and economic growth.

He advocated a secular state where people of all religions could practice their religious beliefs freely and vigorously. His vision aimed to maintain religious tolerance and inclusion in the country.

Bangabandhu's dream was ambitious and aimed to transform Bangladesh into a modern, progressive and self-reliant state.

Bangabandhu Sheikh Mujibur Rahman's brutal killing is a cause of deep regret for the Bengali nation for several significant reasons. Bangabandhu Sheikh Mujibur Rahman was the founding leader of Bangladesh and played a leading role in the country's struggle for independence and its early years as an independent nation.

His vision, leadership and dedication to the welfare of Bengalis was instrumental in shaping the nation's identity and direction. As a result of his assassination, the Bengali nation lost a visionary leader who showed the ability to lead Bangladesh towards progress and prosperity.

Bangabandhu's unwavering commitment to Bangladesh's independence led to long and repeated imprisonments and personal sacrifices. He endured years of struggles and adversities and fought for the freedom of the country. His brutal murder created a tragic end in the life of the Bengali nation. Bangabandhu sacrificed himself for the betterment of his people and country.

The assassination of a democratically elected leader is a serious blow to the principles of democracy and the sanctity of elected governance. This disrupts the democratic process and plunges the nation into a long period of political instability.

Bangabandhu Sheikh Mujibur Rahman is called the 'Father of the Nation' in Bangladesh. His memory is cherished; he holds a special place in the hearts of Bengalis. His assassination is a deep loss that the nation still feels, as he represented the aspirations of crores of Bengalis.

Although Bangladesh has made significant progress since its independence, regret for Bangabandhu's brutal assassination is a reminder of the challenges in protecting democracy and human rights, and the need to ensure justice and accountability in such tragedies.

Democratic governance returned to Bangladesh through free, independent and peaceful elections under the leadership of Bangabandhu Sheikh Mujibur Rahman's daughter Sheikh Hasina. Since being elected Prime Minister in 1996, Sheikh Hasina has led the government of Bangladesh several times. She played an important role in shaping the political scenario of the country and implementing various developmental initiatives.

Bangabandhu's contribution and dream of a united and prosperous Bangladesh has left an indelible mark in the nation's history. After his assassination, his daughter Sheikh Hasina has been working tirelessly to fulfill Bangabandhu's dream and build a golden Bengal. She has become a prominent political figure in Bangladesh and the outside world. She is playing an important role in advancing Bangabandhu's vision and goals. It is said that she has made Bangladesh a role model for development.

August 15, 1975 was a tragic event in the life of the Bengali nation. On this day, despite the tragic killing of Bangabandhu Sheikh Mujibur Rahman, the best father of the Bengali nation for a thousand years, his contribution to the country's independence and nation building is remembered with respect in the country and outside the country. By defeating all the negative forces and turning grief into strength, the Bengali nation is moving towards development and progress. Get motivated to move forward. As a visionary leader and "Father of the Nation", Bangabandhu is and will remain an eternal beacon in Bengali life for the progress and development of the country.

Dr. Matiur Rahman: Researcher and development worker.


Whither Bangladesh Jamaat-e-Islami?

Ankita Sanyal
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In June, a new party, the Bangladesh Development Party, applied for registration with the Election Commission of Bangladesh. It has been known for some time that the Bangladesh Jamaat-e-Islami – which was deregistered as a political party in 2013 since its constitution contradicts the Bangladesh Constitution – has been contemplating its political future by forming a new party.

There has been a debate since 2016 regarding whether the party should reincarnate itself as a new party since all its top leaders had been convicted of war crimes. In 2018, the EC decided not to ban the party, but to cancel their registration following a 2013 High Court order that declared the party's registration illegal. The party would have probably preferred a ban so as to justify the formation of a new party, and also because, if Jamaat is dissolved without a ban, it would essentially be confirming its negative role in the Liberation War.

The War Crimes Tribunal and the hanging of several top leaders of Jamaat after they were convicted has been contested by the party. After 2008, it decided not to participate in the 2014 election following the decision of its alliance partner, Bangladesh Nationalist Party (BNP). It participated in the 2018 election under the BNP symbol, as part of the 20-party alliance. Though there was reluctance to include Jamaat in the electoral alliance, given its role in the Liberation War, political expediency prevailed in the end.

Jamaat and BNP: Tactical separation?

Prior to the 2018 election, several leaders within BNP had urged the party to end its alliance with Jamaat. This call for separation was also made by the European Union in 2015, as it was widely believed that Jamaat cadres were involved in widespread violence that had resulted in more than 100 people being killed. Though there was some debate within BNP about its association with Jamaat, in the end it was decided it would not to cut off ties.
Jamaat-e-Islami head Dr Shafiqur Rahman, in a meeting held in August 2022, said, "The alliance has become ineffective." In January this year, BNP and Jamaat held separate programmes. Though some leaders within the BNP attributed Jamaat's decision to go separate ways as "good riddance," the fact remains that the BNP did not have the political courage to de-link with Jamaat. Therefore, this separation appears to be tactical.

After a decade, Jamaat was allowed to hold a rally in Dhaka on June 10. The permission to hold the rally at the Institution of Engineers, Bangladesh (IEB) was granted by overriding another request made by Jatiya Party's youth wing, Jatiyo Jubo Sanghati. Some even speculate a possible understanding between Jamaat and the Awami League, as it has been stated from the government's end that the permission was granted due to "a political decision.

As of now, the two erstwhile allies are holding rallies separately while keeping their options open. Jamaat has always been close to BNP, but seems to have realised that a tactical separation would help it to survive the political turmoil, as Awami League remains focused on discrediting BNP.

Jamaat and the West

Jamaat-e-Islami remains the largest Islamic fundamentalist party in Bangladesh. But it shares an interesting relationship with the Western countries, especially with the US and those in the European Union. At one point of time, Jamaat was even promoted as a moderate Islamic party. Yet, the US Department of State Country Report on Terrorism 2006 had indicted the Islami Bank, which had several board members belonging to Jamaat, for funding the Jamaat-ul-Mujahideen (JMB), a terrorist organisation. Similarly, it is also known that one of the former JMB leaders, previously Habiganj district head of Jamaat-e-Islami, Saidur Rahman was a rokan of Jamaat. However, Jamaat immediately distanced itself from him and argued that Saidur did not belong to the party and had left it a long time back. In 2014, its student organisation was involved in violence against minorities. Though Jamaat in the past has distanced itself from Bangladesh Islami Chhatra Shibir, which many believe is the armed wing of the party, most Jamaat leaders in their student days have engaged in politics through Chhatra Shibir. The party has also been at the forefront of a campaign to declare the Ahmadiyya as non-Muslims.

While the EU has been vocal in the past about Jamaat in several of its resolutions, asking the BNP to sever its ties with Jamaat, the US has kept rather quiet regarding the party. In a confidential note, as revealed by Wikileaks, the US Embassy in Dhaka in January 2010 wrote, "Mission Dhaka will continue to engage with Jamaat and Shabbir [Chhatra Shibir] and track their efforts to transform Bangladesh into a more Islamic state." On July 24, the US ambassador met with the main party functionaries of Jamaat. Meanwhile, the European Union Parliament, following the 2007 violence, had urged the BNP to unequivocally distance itself from Jamaat-e-Islami and Hafezat-e-Islam, which are regarded as the main instigators of the violence, stressing that parties which turn to terrorist acts should be banned.

Jamaat-e-Islami as a party insists on Islamic values and maintenance of purdah. Some of the writings that appear in the newspaper that is controlled by the party discourages mingling between opposite sexes, discourages women from working with men as it would lead to fitna, and argues that the prime responsibilities of women are taking care of their husbands, children, and doing household chores.

Whither Jamaat-e-Islami?

However, the question is, while the Bangladesh Development Party (BDP) – which many think is a front organisation of Jamaat – is waiting for registration as a new political party, why does Jamaat want to display its political strength by organising rallies, instead of allowing the BDP to emerge? This brings us to another question: is Jamaat expecting the restoration of its registration by the EC? Since it is an established political party, receiving votes in its name would rehabilitate the party in the country's politics, especially post the war crime trials.

Another relatively new party, Amar Bangladesh Party, which is headed by former Jamaat activist Mujibur Rahman Manju, has been denied registration by the EC. AB Party projects itself as a reformist party that does not want to burden itself with the history that Jamaat inherited due to their role in supporting the Pakistan Army during the Liberation War. In 2019, Barrister Abdur Razzak resigned from Jamaat, citing the party's role in 1971. Such reformist moves within Jamaat are not new.

The party has so far dodged this issue by expelling those who have raised such questions and has survived as a prominent Islamist political party with ideological and monetary strength. Not surprisingly, Jamaat has managed to surface, with its cadres intact, to take the opportunity that the upcoming national election provides. For now, it does not seem in a hurry to implement its larger Islamisation project. But in its hurry to have a multiparty election minus BNP, the AL's flirtation with Jamaat may have serious implications for Bangladeshi society and politics.

Author Ankita Sanyal is working as an Associate Research Fellow at International Centre for Peace Studies (ICPS) in New Delhi.


The Devastating State of Breast Cancer Patients in Chittagong Medical College Hospital

Nyma Hossain
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Breast cancer, a life-threatening disease, has the highest prevalence compared to any other type of cancer in Bangladeshi women, yet little to no women above the age of 35 know about the following cancer. That is why, this incident increases significantly each year due to poor socio-economic status, illiteracy, unawareness of the people and lastly, lack of confidence of the patients which leads most women to go to doctors late which results in the disease entering a second or third stage and treatment becomes very complicated and costly.

Over a dozen of breast cancer patients were interviewed in Chittagong Medical College Hospital and not a single patient knew about a cancer related to breast before diagnosis. Among those patients, only one crossed the boundary of the high school or passed SSC. Many of them barely studied till class 6 and some of them never went to school. They also come from a poor socio-economic status and few cannot even afford the treatment. As most of them come from a conservative society, they do not talk about it much and are ashamed of it.

44 years old Jitu Begum, a victim of breast cancer, was suggested to seek homeopathy treatment by the people of her village when she started to feel a lump on her breast. As a result, the tumor was left untreated and her condition worsened. The doctors informed her, leaving the tumor untreated for a long period of time caused the cancer.

50 years old Mojlish Begum, also a victim of the same tragic fate, was diagnosed with cancer 5 years ago but stopped the treatment as she couldn’t afford it anymore. It led her condition becoming from bad to worse.

Studies show that women from poor socio-economic status and with no or low education are often victims of late presentation and tend to have a higher stage at diagnosis. Poverty, literacy and assorted risk factors have influenced the outcome of breast cancer cases among Bangladeshi women.

As the primary method of breast cancer diagnosis is biopsy, patients need to contact a doctor as soon as they notice abnormal symptoms. By doing this, patients have a significantly better chance of surviving cancer and potentially avoiding cancer is what experts say.

None among all the interviewed patients knew about the existence of breast cancer despite breast cancer being the most common cancer in women in Bangladesh. Lack of awareness and society’s conservativeness are the reason why these women are in such ill-fated and painful situations. We should consider it a forewarning now that if proper steps are not taken to spread awareness among women of Chittagong about breast cancer, the condition of breast cancer patients will only get worse in the near future.