A mute time bomb is ticking in the form of acquired immunodeficiency syndrome (AIDS) and Bangladesh needs to defuse the threat right now to keep productivity up.
■Reducing malnutrition and Improving the quality of education are the two major challenges facing the country, because factors like these bring down people's productivity and their learning capabilities." said Eduardo A Dory an, World Bank Vice-President for Human Development in an interview with The Dally Star.
Unless Bangladesh urgently addresses the Issue of HIV or AIDS, the silent time bomb will blow up in ten years’ time, making the reversal of the situation pretty impossible." said Doryan.
The African experiences tell us that many of the countries in the continent had similar HIV situations like In Bangladesh. But since the issue was not adequately addressed, it gradually swelled up Into the current appalling proportion. Countries like Bangladesh are not first enough to tackle the looming threat from AIDS. Doryan observed.
Regarding fighting malnutrition and bettering the quality of education, he said Bangladesh has proved that it can successfully handle far more difficult challenges.
"Given the fact that Bangladesh has the potential to successfully do many difficult Jobs like bringing girls to schools and lowering trie birth rate, the goal of reducing malnutrition is also achievable. Similarly, the country can also face up to the challenge of Improving the quality of education." said Doryan.
The World Bank is now working with various countries to establish a much more integrated link between the population. reproductive health and basic health issues.
"One major challenge is to provide the people from thana level to downwards an Integrated package of preventive medicines and healthcare facilities. This would have a big impact on the people's life expectancy. child mortality and nutrition."
"For this, you need to have an synthesised set of services provided by NGOs and the public sector with the objective of reaching services closer to the people." Doryan said.
"In general, the global experience shows that once you bring services vet^wosc to needy poor, you need to have in place a referral system. Tills Indeed has proved a success in many Latin American and the Eastern European countries.
This system could be developed through an effective delivery system by NGOs and private companies with support from the public sector, or through a fully public-funded system to make ft equitable. This has to be very efficient and well-tar-Sted to serve the poor and not e well-off. ,
"But the effective delivery system is an essential element in this which Implies good regulatory role of the state. This means that health sector governance Is an Important issue." he said.
Dwelling upon the World Bank's new' Comprehensive Development Framework (CDF), he said this has radically changed the Bank's view regarding development.
"It indicates a major change in the Bank's thinking because only 10 years ago. the WB was focused on financial reforms and Infrastructure lending. But with CDF. equal importance has been given to sound macroeconomic environment and human development." he explained.
The launching of CDF has 'made us more outcome-ori-
ented. In the past, WB was keen on projects and was eager to see how many schools and clinics
were being built. But the outcome-orientation would lead us to quality. We would want to know if those kids who are going to clinics or schools are availing themselves of proper healthcare and education facilities. It is easier to build schools than- getting kids really learn something. And ensuring quality is not a costly affair, because when there are bad services all around, people have to pay more for quality ones." he said.