Dr. Md. Abdul Latif : The Universal Declaration of Human Rights (Article 25) and the International Covenant on Economic, Social, and Cultural Rights (Article 12) highlight that healthcare access, encompassing essential medicines, is a basic human entitlement, with pharmaceutical capabilities able to tackle health emergencies and secure lasting medication accessibility. The COVID-19 pandemic has exposed the vulnerabilities in Bangladesh's healthcare system, which faces significant challenges in the global fight against the coronavirus. Between 2020 and 2021, the country navigated various outbreak stages, resulting in widespread infections and deaths. According to official data from the Directorate General of Health Services (DGHS), the virus has claimed 29,481 lives and infected 20,46,823 people. The failure of drug discovery and inadequate readiness, coupled with a lack of research and development initiatives during the COVID-19 crisis, is exacerbating the health crisis in the country. Bangladesh struggled to secure a consistent supply of COVID-19 vaccines, due to export restrictions, global supply chain disruptions, and increased demand.Though Globe Biotech, a local pharmaceutical company, developed the Bangavax vaccine and obtained phase I clearance for human trials from the relevant authority, the vaccine ultimately did not reach the market as a COVID-19 vaccine.In this context, enhancing pharmaceutical capabilities is a pressing need for a healthy Bangladesh.

The World Health Organization (WHO) notes that Dengue, a viral infection transmitted through the bite of infected mosquitoes, is endemic in Bangladesh, with recurrent outbreaks, and is a major public health concern affecting all 64 districts. Although Dengue was first recorded in Dhaka in 1960, its outbreaks were minimal until 2010, when it began to coincide with favorable climatic conditions, such as the rainy season from May to September with higher humidity and temperatures, leading to epidemics in the country. As of December 7, 2023, the Health Emergency Operation Center and Control Room, DGHS reported that 316,160 people (40% women and 17% children) had been infected with Dengue, resulting in 1,643 confirmed deaths (57% female, 10% children). This highlights the Dengue virus's potential to cause epidemics, resulting in high morbidity and mortality. Furthermore, the number of cases and deaths is higher in 2023 compared to similar periods in the past five years. Dengue Virus 2 (DENV2), the most dangerous strain, has been identified as the primary circulating serotype in this outbreak, which may result in more severe Dengue infections and hospitalizations due to a second infection with a heterologous serotype. The combined impact of COVID-19 and Dengue is severe for affected individuals. Unfortunately, there is still no specific treatment for Dengue, and clinical management relies on supportive therapy to control pain symptoms with Acetaminophen (paracetamol).

To prevent Dengue, a deadly viral disease, Bangladesh has implemented environmental measures to mitigate the threat, as no approved Dengue vaccine is currently available in the country. Notably, a promising vaccine candidate, jointly developed by the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) and the University of Vermont's Larner College of Medicine, USA, has completed phase 2 trials of TV005, a single-dose, tetravalent Dengue vaccine.

Chikungunya fever, another viral illness caused by an arbovirus, triggered a nationwide epidemic in 2017 and remains a growing concern in our country. What's more, chikungunya can be fatal when combined with Dengue infection and co-morbid conditions, such as hypertension and diabetes. Moreover, distinguishing chikungunya from Dengue based solely on clinical findings is extremely challenging.

The country faces significant public health challenges from both communicable and non-communicable diseases, exacerbated by climatic and socio-economic factors, underscoring the urgent need to improve therapeutic capabilities for public health preparedness. While the pharmaceutical sector meets 97% of domestic demand, with projections estimating the market value to exceed US$6 billion by 2025, challenges remain in producing life-saving vaccines and drugs. Key issues include inadequate investment, dependence on imported raw materials, and poor infrastructure, particularly a lack of modern equipment. Additionally, regulatory and policy barriers, such as a weak regulatory framework and insufficient standardization, further hinder capacity and capability, reflected in limited research and development and a shortage of skilled professionals.

Bangladesh, on the path to graduating from the Least Developed Country (LDC) category, benefits from a Trade-Related Aspects of Intellectual Property (TRIPS) Rights waiver to manufacture generic versions of patented drugs (e.g. Cancer, HIV treatments), aiding the delivery of healthcare services for prevention and treatment within the nation. As per the LDC Portal, United Nations, and the Ministry of Commerce, Bangladesh, the country is scheduled for graduation on 24 November 2026 from the Least Developed Country (LDC) status, and after 1 January 2033, TRIPS Rights waiver will phase out and the country will need to comply with TRIPS agreements fully.A study bythe General Economics Division (GED) forecasted that afterthe special transition period of the post-LDC era, local pharmaceutical companies may face increased competition from other countries, cutbacks in the productionand export of patented generic medicines due to avoiding the violation of TRIPS agreement and this drops of production may affect prices of drugs and move towards concentrating the market with few influential players.Suppose we do not take the initiative to boost the country's pharmaceutical potential in the TRIPS waiver regime. In that case, companies will struggle to comply with international regulations, lose market share, become dependent on imported products, and the market will become unstable, denying people access to lifesaving drugs at affordable prices.

Ensuring access to medicines is a critical component of human security and the WHO highlights the urgent need for equitable access to medicines to combat public health emergencies. By creating a conducive atmosphere for drug discovery and vaccine invention, Bangladesh can address local needs (e.g., Dengue, Chikungunya), enhance self-sufficiency, improve accessibility to medication, and encourage innovation, entrepreneurship, and economic growth. A streamlined patent application process, skilled and sufficient patent examiners, a robust legislative framework, and protection of intellectual property rights are essential prerequisites for successful drug discovery and vaccine invention. With its own vaccine production facilities and drug discovery capabilities, Bangladesh can negotiate better deals with international partners, ensuring access to vaccines and medicines at affordable prices.

Bangladesh must prepare to combat new health threats in the days ahead. By enabling pharmaceutical potentials in the TRIPS Waiver Regime, Bangladesh will be well-equipped to respond to emerging health threats, crises, or pandemics, securing healthy national and global health security. This will demonstrate the country's commitment to upscaling its image, ensuring developmental sustainability, and safeguarding national security as it graduates from LDC status.The Writer is a Global Ambassador & ADB-JSP Scholar