Is it still possible for Bangladesh to contain Covid-19?
Like many countries across the world, Bangladesh has been hit hard by the coronavirus pandemic. According to the World Health Organization (WHO), Bangladesh is in the fourth and last stage of Covid-19 transmission, which means that the disease has become native to the population as the numbers of cases and deaths have started to grow rapidly. On the contrary, there are some countries (e.g. New Zealand, South Korea and Vietnam) that have successfully tackled its transmission. Bangladesh may not be comparable to the high-income countries like New Zealand and South Korea. However, the country can be compared to a large extent to Vietnam because both Vietnam and Bangladesh belong to the lower-middle-income status, are densely populated, and share economic and educational ties with China, where the outbreak first occurred in December 2019.
Vietnam has been recognised as a model for low-cost response to Covid-19 by the WHO. The country has reported only 372 confirmed cases and a zero death toll as of July 16, successfully containing the spread of Covid-19. The situation in Bangladesh is quite the opposite. With 1,96,323 confirmed cases and 2,496 deaths as of July 16, the country continues to struggle to combat the disease. This has raised some questions: What has Vietnam done to contain the disease successfully? Can Bangladesh control the transmission of Covid-19 by following Vietnam's example? These questions can be answered by comparing the response of Bangladesh to Covid-19 to that of Vietnam.
Effective public campaigns
It is impossible to contain an infectious disease without the active participation of the general population in the campaigns. Vietnam understood this early and launched two successful campaigns to raise awareness about the prevention of Covid-19 among the mass people. On the one hand, the resource-limited country made a catchy music video and disseminated clear, effective messages about the importance of hand washing. On the other hand, it initiated a fundraising campaign to purchase medical and protective equipment for healthcare workers. Over USD 2.1 million was raised by April 5.
Bangladesh, by contrast, delayed public campaigns and distributed coronavirus information through radio, newspapers and televisions from March 1. However, the public campaigns for Covid-19 prevention often conveyed mixed messages to the general public, which created confusion and misunderstandings. For example, many people appeared to have misunderstood the meaning of the word "quarantine". Importantly, as available evidence suggests, while the Bangladeshi government has not launched any fundraising campaign, its allocated funds for Covid-19 prevention were also embezzled to a large extent.
Research into developing testing kits
Vietnam's remarkable success to control Covid-19 may be attributed to its innovative research, leading to developing Covid-19 testing kits early. The Vietnamese Ministry of Science and Technology held a meeting with virologists to inspire the development of diagnostic tests in late January 2020. By early February, government-funded institutions in Vietnam had developed more than four Covid-19 testing kits that were certified by the Ministry of Defence and the National Institute of Hygiene and Epidemiology. Subsequently, two private companies, namely Viet A and Thai Duong, manufactured the testing kits. Despite its limited Covid-19 cases, Vietnam scaled up testing capacity with sixty-three testing sites across the country to stop community transmission.
By contrast, although Bangladesh needed to have massive testing facilities, it has established only 43 diagnostic laboratories and the total testing of Covid-19 cases has shown a decreasing trend (BBC Bangla, July 10). Notably, the bureaucratic red tape thwarted the process of developing a testing kit by Gonoshasthaya Kendra.
The Vietnamese government promptly conducted three levels of contact tracing for each positive case, including identifying the second, third and fourth levels of contacts of infected individuals. Also, pharmacies across Vietnam provided information about individuals buying cold and flu medicines to the government. However, in Bangladesh, contact tracing is principally centralised and done in Dhaka, and at district and sub-district levels to some extent. Such lax and slipshod ways of tracing contact contributed to the increasing trend of Covid-19.
Vietnam's response to Covid-19 can be characterised by its mandatory use of face masks in public places since mid-March. The country has enforced a licensing system for shipping and trading of face masks and hand sanitisers and applied hefty fines for traders who are found to be gouging prices or producing fake masks. By contrast, in Bangladesh, counterfeit masks and hand sanitisers have flooded the markets due to limited or no monitoring and regulation of the production and sale of non-pharmaceutical equipment. This has potentially contributed to the increased transmission of Covid-19 in Bangladesh.
Vietnam's response to Covid-19 can be characterised by its relatively high investment in its health care system, with public health expenditures per capita increasing at an average rate of 9.0 percent annually between 2000 and 2016. These vast investments are paid off with better treatment for Covid-19 patients with no deaths. On the other hand, the healthcare system remained neglected in the Bangladeshi government's priorities. The budget for providing the healthcare needs of the large population has remained the lowest in South Asia, with only 4.9 percent of the national budget. This suboptimal investment in health sector, together with the inefficient utilisation of allocated resources, certainly makes it difficult to meet the new spending needs of a pandemic like Covid-19 and it may have increased the number of deaths related to Covid-19.
A comparative analysis, thus, shows how effective public campaigns, innovative research into developing testing kits, widespread contact tracing, monitoring and regulation of non-pharmaceutical equipment, and adequate health investment, together with strong political commitment and leadership, have greatly contributed to reducing the transmission of Covid-19 and zero deaths in Vietnam—while the opposite scenario is observed in Bangladesh.
Clearly, the war against Covid-19 is not over yet in any of the countries and may continue until effective treatment and vaccine become available globally. No doubt this has been true enough for Bangladesh because the country adopted tardy and inadequate control and containment measures to fight against Covid-19 despite being a highly vulnerable country. As such, Bangladesh can follow some of the control measures that Vietnam has undertaken to successfully tackle the disease. Although Bangladesh has delayed adopting adequate and effective control measures, it may still be possible for the country to contain Covid-19 and decrease the overall size of its outbreak. Bangladesh has a lot to learn from Vietnam in fighting against the Covid-19.
Md Nazmul Huda is a PhD candidate and an academic in the School of Public Health and Community Medicine at the University of New South Wales, Australia. Md Kamrul Hasan is a staff member at the Western Sydney University, Australia.