Bangladesh Institute of Tropical and Infectious Diseases (BITID) is the only government national institute in Bangladesh established with the objective of providing specialized clinical services, producing human resources and conducting research relevant for the tropical and infectious diseases. There is no dedicated philanthropic or private institute/hospital in Bangladesh to deal with tropical and infectious diseases. The diagnostic and clinical services in Bangladesh for the infectious diseases has been continuously lagging behind comparison with other organ specific conditions despite enormous improvement happened in health services in recent years. To cite few examples, we can not diagnose most of the acute fever in terms of cause, diarrhoea is diagnosed on the basis of syndrome, childhood infections and UTI are managed as per syndromic criteria, time old tropical disease snakebite is not even in the disease list, most of the infectious diseases are managed at first contact by community health workers through task shifting or by non accreditated informal health providers (‘village doctor’ or dispensers at medicine shop) , diagnosis of infections are mostly not evidence based due lack of proper microbiology lab even in medical college and district hospitals.
The BITID was established with enthusiasm and vision with a defined Road map. It is laudable that within limited resources and space BITID already started providing/conducting some exemplary services and research relevant for the control of infectious diseases in the public sector for example Xpert for diagnosis of tuberculosis and resistant tuberculosis (collaboration with national tuberculosis program), identification of resistant malaria among Rohingya population (collaboration with national malaria elimination program).A domestic and international collaboration model was considered for flourishing and sustenance of the institute having the experience of some exemplary works conducted by scientists associated with the promotion of such an institute in Bangladesh for example, series of activities initiated by Malaria Research Group (MRG), Bangladesh Association for Advancement of Tropical and Infectious Diseases (BAATM), and Toxicology Society of Bangladesh (TSB). Despite provision of very limited resources the initial physical infrastructure of the Institute was set up within short time and positions of partial human resources was promulgated by the government for the beginning of BITID rightly considering enormous importance of the relevant services and development. With such a vision the government facilitated the set up of a collaborative advanced microbiology lab at BITID with the support of Fondation Merieux (France) for conducting research in infectious diseases. Meanwhile the potential of the lab has been appreciated by setting up surveillance site, prevention services for rabies and advanced TB diagnostic facility by the government and there is many more further potential areas for collaboration.
With limited faculty and staff meanwhile BITID could drew the attention of the government by good performance in improving the understanding of various aspects of infectious diseases important for Bangladesh. A national and international collaboration for evidence generation has already been started in some areas and evidence is coming up through such collaboration.
The government should consider the utilization of initial investment made by: starting postgraduate course (MD Tropical and Infectious Diseases), using the facility for providing training to human resources for control of various infectious diseases of public health importance, completion of the first phase of the physical infrastructure, having human resources in place with the positions already within the organogram and make an initiative for further expansion to fulfill the objectives of only such national institute, BITID.
In 21st century the importance of infectious and tropical diseases can not be underestimated considering the contemporary disease scenario across the globe and in Bangladesh. Infectious diseases should be taught with emphasis during academic teaching in graduate, postgraduate and other health care professional courses. Separate department and unit for teaching and management of infectious and tropical diseases in medical colleges & hospital and in medical universities is long overdue. Urgent maintenance and up gradation of a number of Infectious Diseases Hospital established in Bangladesh long before is needed.
Government can utilize BITID and can entrust to play the pivotal roles in improving the situation to address infectious and tropical diseases in Bangladesh consistent with development of the country.
Important Timelines of BITID
|1.||Submission of a concept paper by professor Md. Abul Faiz, the then professor of Medicine, Dhaka medical colleges to the secretary MOHFW for setting up of a Tropical Medicine Centre in Chattogram||24.01.2005|
|2.||Forwarding of the concept paper to DGHS by MOHFW||04.06.2005|
|3.||Included in Health, Nutrition and population sector Programme (HNPSP), Revised Programme Implementation plan RPIP, original in July 2003-2006, Revised in July 2003- July 2010, Planning Wing Ministry of Health and Family Welfare, Government of the people’s Republic of Bangladesh||04.02.2005|
|4.||Proposal for setting up of ‘Bangladesh Institute for Tropical & Infectious Diseases’ by Civil Surgeon, Chittagong to MOHFW||10.07.2005|
|5.||Submission of the Scheme summary of BITID to the joint Chief planning MOHFW from DGHS||12.06.2007|
|6.||Formation of the ‘Core Group’ to assist in the implementation of BITID||28.07.2007|
|7.||First Foundation stone laid||07.09. 2007|
|8.||Selection of Focal point of BITID, Professor Md. Abul Faiz, Principle, DMC||28.11.2007|
|9.||Preparation of the road map for establishment of BITID by the Focal point through assistance of country office of WHO. Submission of the Road map of BITID to MOHFW by DGHS||19.02.2008|
|10.||Permission to use Mymensingh SK Hospital as Kala azar Treatment and Research Center of BITID||30.12.2008|
|11.||Creation of different posts of MOHFW by DGHS for BITID||01.12.2010|
|12.||Declaration of Intent (DOI) between BITID (under MOHFW) and Fondation Merieux, France was signed for the development of a Biosafety Level 2/ Level 3 lab in BITID||03.04.2011|
|13.||Administrative approval to commence activities of BITID||01.12.2011|
|14.||Handing over of the BITID building by CMMU||20.06.2012|
|15.||20 bedded ID hospital was given under the control of BITID||20.09.2012|
|16.||Memorandum of understanding (MOU) was signed between BITID & Fondation Merieux,||20.10.2012|
|17.||Sanction of new economic code for BITID||14.12.2012|
|18.||Honorable Prime Minister of Bangladesh Government Sheikh Hasina hadinaugurated BITID||26.01.2013|
|19.||Outdoor service has been started from||23.03.2013|
|20.||MoU withInstitute for Developing Science and Health Initiatives (ideSHi) was singed||23.01.2014|
|21.||Anti Rabies Vaccine (ARV) program has been started from||24.09.2014|
|22.||MoU withCenters for Disease Control(CDC) was signing||25.04.2016|
|23.||EPI program has been included in EPI||12.04.2017|
|24.||New indoor facilities at BITID own premise extension of Indoor, BITID||08.08.2017|