My career began in 2016 at the Institute of Epidemiology, Disease Control and Research (IEDCR) on a US-CDC-funded global health security agenda project. This early role gave me the firsthand opportunity to understand the complex interplay between humans, animals, and environmental health. I witnessed how development partners and national efforts controlled outbreaks by strengthening zoonotic disease surveillance, rapid response, capacity building, and cross-sectoral collaboration.
In 2019, I transitioned to a leadership role to train government veterinarians in field epidemiology, focusing on surveillance and outbreak responses supported by development partners. Mentoring the fellows, I saw the transformative impact of a skilled workforce capable of early detection, rapid response, and integrated One Health approaches.
These examples extend to critical areas like long-term wildlife surveillance through the USAID PREDICT program and capacity building to protect our proud symbolic tiger in Sundarban. USAID’s Feed the Future Bangladesh project significantly improved livestock production and nutrition, while FAO-ECTAD’s U2C initiative tackled the silent pandemic of antimicrobial resistance. Notably, in 2023 alone, USAID directly supported the identification and reporting of over 250,000 new TB cases in Bangladesh. That same year, 296,487 TB cases were cured or successfully treated through USAID-backed programs. These were not just statistics; they represented lives saved and the halting of community transmission.
The impact of USAID’s and other US agency support is undeniable and translates directly into improved lives. This assistance has significantly strengthened Bangladesh’s fight against tuberculosis, improved child nutrition, protected forest biodiversity, and supported outbreak surveillance in humans and animals. These achievements are a testament to our resilience and determination.
But this progress comes with a vulnerability that we must confront now!
The recent federal funding cuts by the new US Administration across the agency and the subsequent dismantling of the USAID foreign support left some countries exposed. The ripple effects of foreign aid cuts reached our globally renowned ICDDRB, forcing the layoff of 1,000 employees.
One central question emerged during this crisis: How long can we build a health system on borrowed stability? Bangladesh must transition from dependency to ownership guided by a One Health framework that is locally led, regionally integrated, and globally aware to ensure resilience.
Bangladesh is always vulnerable to emerging health risks, from diphtheria outbreaks in Rohingya camps to vulnerabilities in our tuberculosis treatment system and the recurring threat of Nipah encephalitis. This is no longer an abstract concept but a harsh reality. The country must invest in coordinated surveillance, livestock and wildlife monitoring, community education, and early response to ensure health security—all core elements of the One Health approach.
Most importantly, these systems must be rooted in national ownership rather than a fragile or externally driven system that will never move fast enough to stop the subsequent spillover. A locally led, regionally integrated, and globally aware One Health framework ensures resilience and prevents future health crises. Otherwise, despite making undeniable progress, we will remain structurally vulnerable.
When I use the term ‘decolonization’ in the context of health security, I am not referring to the rejection of global support. Instead, I am advocating for Bangladesh to set its own priorities and take ownership of its health security. We must all commit to this responsibility, and it is the only way to ensure a resilient and sustainable health system for our country.
One Health approach is no longer academic; its practicality is increasingly evident, especially in countries like Bangladesh, with dense populations and a unique interface of humans, livestock, and wildlife. The COVID-19 pandemic was a wake-up call from nature to rethink how we understand and approach health.
Climate change makes the ecosystem more vulnerable to disease emergence and vector spread. Investing in an organically grown, integrated, locally governed system is the only way to ensure early warning, rapid outbreak response, and a cost-effective formula for ensuring health security.
A 5-point plan for shifting from dependency to resilience
To secure our healthy future and protect the environment for the next generation, Bangladesh must:
- Sustained investment in integrated surveillance, laboratories, and workforce capacity building, including field epidemiology training programs that act as disease detectives.
- Institutionalize the One Health approach in the relevant health, livestock, and forestry departments to ensure the maximum synergistic outcome of the earned resources from its core budget.
- Build effective public-private partnerships in critical health domains, including food safety, antimicrobial resistance, etc.
- Build a natural digital infrastructure to link human, animal, and environmental health data and make sense of data by utilizing it for policy development.
- Strengthen regional south-south collaboration and knowledge partnerships (e.g., India, Vietnam, Indonesia) to share innovative, low-cost solutions.
Health security IS national security, and we realized it during the COVID-19 pandemic. Bangladesh has made impressive progress in its defense structure and is doing the right things. However, it is notably fair to say that the following existential threats might not originate from the border but from a poorly monitored backyard farm, distressed wildlife, or wet markets. Therefore, just as we invest in military defense, we must also invest in pandemic preparedness, AMR surveillance, and resilient health systems.
A future must be led from within; decolonizing does not mean cutting ties with development partners but instead rethinking the system approach to redefine the partnership. As someone who began his career journey within a foreign-funded health program and benefitted from the resources, training, and vision of the program, I remain grateful. But the time has come to lead those initiatives by ourselves.
Because of the future of Bangladesh’s health and environment, its strength, equity, and sovereignty must be designed, led, and sustained by us.
