This is a narration of beginning of beginning of translation of a dream in to reality. Bangladesh Institute for Tropical and Infectious Diseases (BITID) has been inaugurated by Prime Minister of Bangladesh on 26January 2013. This edifice between hills at the green skyline and sea at the blue horizon of Chittagong has been continuing to emerge a center of excellence in the region and beyond. The institute is the reverie of some teachers of Chittagong Medical College along with their scientific and operational collaborators in home and abroad with passion of scientific research. They had been in the lane of the operational research on some endemic tropical and infectious diseases those are public health problems of the nation with high morbidity and fatality. Malaria, Dengue, Leishmaniasis, TB, Filariasis, Snake bite, Rabies and epidemics of mutant viral diseases, to name a few. These workers have organized themselves in an assembly ‘Malaria Research Group'(MRG) and fast gained credibility off relevant works, documentations and publications.MRG subsequently have been entrusted responsibility for operational research to provide evidence andscholastic input to the respective national control programs. There are always threats of emerging and remerging and newer infectious and tropical diseases so this linkage has been found very productive.MRG while extending scholastic helps for preparation of national guidelines and control programs had realized country specific data and strategy are needed to control these public health menaces. Keen observation had revealed though these comprise the great bulk of caseloads and fatality there were very meager specialized approaches and operations in this behalf. To carry forward a dynamic professionalism an organization Bangladesh Association for Advancement of Tropical Medicine (BAATM) was established in 1996. MRG and BAATM have been working in synergy the former gathering the evidence and the other for sensitization and onward dissemination. Down the sojourn of works MRG and BAATM had been perceived the need for a customized center for continuing the research for funneling to education for consolidating service and had conceived the idea of BITID. This was first articulated in the recommendations of Meeting2001 of BAATM on 14 April in Chittagong as a dream. Subsequently in Meeting 2004 of BAATM this dream was again more emphatically expressed in the recommendations at BCPS auditorium. The then Ministry of Health and Family Welfare (MOHFW) upheld the vision of BITID with much applause. On 24January 2005 a concept paper on BITID was submitted by Principal Investigator of MRG and Secretary General BAATM Professor M A Faiz to Secretary MOHFW, that was down passed on 04 June 2005 to DGHS for sizing per rules of business. On 10 July 2005 a parallel proposal was submitted by Civil Surgeon of Chittagong to MOHFW. In the Meeting 2007 of BAATM that was held at BICC the Adviser for MOHFW of Care Taker Government of then declared the formal approval of BITID and subsequently a modest fund was allotted for initial work up. Included in HNPSP, Revised Program Implementation Plan (RPIP), Original in July 2003-2006, Revised in July 2003-July 2010, Planning Wing of MOHFW, GOB cleared finally the establishment of BITID. During the preceding and following few months Secretary of MOHFW, DGHS and other officials along with the MRG members in many occasions met and looked for the site. Under the Chairmanship of Professor Emran Bin Yunus a committee comprising Mr S M Hannan Executive Engineer CMMU, Dr M Mohsinur Rahman Assistant Director Hospital DGHS, Dr M Sajedul Hasan Assistant Director Planning DGHS, Dr M Abul Mansur Khan Assistant Director Planning DGHS, DrMahfuzur Rahman Talukdar Deputy Director Health Chittagong, after all pros and cons review selected the yard of Infectious Diseases Hospital (IDH) in thevicinity of Chest Diseases Hospital (CDH) at Fauzdarhat, Chittagong.This selection was approved by MOHFW. It was on principle decided that both IDH and CDH would bemerged with BITID. The scheme summary of BITID to the Joint Chief Planning MOHFW from DGHS was submitted on 12 June 2007. On 07 September 2007 Major General M MatiurRahman (Retired) Adviser for MOHFW flanked by Secretary MOHFW Mr A K M Zafarullah Khan and Dr Duanvadee Songkhobol WHO Representative(WR) to Bangladeshlaid the foundation stone of BITID in a simple but auspicious ceremony.
During discussion about consolidation of the fluid concept of the BITID it was decided that a Road Map Workshop (RMW)would be arranged with globally recognized resource persons in the relevant arena with those of the country. WR sponsored to fund on the approval of MOHFW.
The RMW was held in three phases. It was participated as resource persons by Dr Melba F Gomes of TDRWHO, DrArjen M Dondorp, Dr Nicholas P Day, Professor Nicholas J White, Professor Polrat Wilairatana of Oxford Mahidol Collaboration Unit at Mahidol University, Dr Vijay Kumar WHO SEARO, Professor M A Faiz, Professor Emran Bin Yunus, Professor M Ridwanur Rahman, Professor M Amir Hossain and DrRasheda Samad of MRG; Dr A M Bangali of WHO BAN, Brigadier General M Rabiul Hossain and Colonel Seikh Bahar Hossain of AMC of Bangladesh Army, Professor M Nurun Nabi, Professor A S M F Karim, Professor MK Chowdhury, Professor Syeda Nurjahan Bhuiyan and Professor Chowdhury B Mahmud as the reputed academia, representatives of M&PDC and Disease Control Agencies of DGHS plus other local and national health administrators, engineering agencies, press and from academic and program outfits.
Phase-I of the RMW has held from 1 through 7 November 20017 with MRG and other national resource and operational personals at MRG office. These resource persons by brain storming and supported by downloads of evidence and documents and references prepared the framework of the proposed organization.
Phase-II of the RMW was held from 29 November through 02 December 2007 at MRG office 4 expatriates joined the national resource persons to fabricated the framework into a complete draft document with narration of mission, vision, objects, setups, operations, funding, monitoring, evaluation, indicators, personnel, collaboration, KSA (Knowledge Skill Attitude) grooming, skill and logistic transfers and other related macro and micro issues.
Phase-III or Final RMW was held from 4 through 6 December 2007 for a formal dissemination, fine tuning and endorsement. The workshop was held at the Emran Auditorium of EITC. To 30 local participants 6expatriatere source persons joined this event. Category of participants was professionals, health and education administrators and mangers, funding agencies, development partners and others. Secretary MOHFW was the Chief Guest in the concluding session on 06 December 2007 where the draft wasfinalized and shaped in to the Recommendations of the RMW for passing to all portals. These recommendations were submitted to the MOHFW immediately. Subsequently a core group was formed by the MOHFW with Professor M A Faiz as the Focal Point and Professor Emran Bin Yunus the Secretary with Professor M Ridwanur Rahman, Professor M Amir Hossain, Dr Rasheda Samad and Professor Syed M Akram Hossain as members. The Core Group with the collaboration of experts of concerned agencies and outfits of DGHS and MOHFW translated the Recommendations of the RMW in to a Formal Project Concept Document and the required strategic and operational annexure.RMW was a unique fore running event of establishment of BITID and there is no similar example in the country for the consolidation and funneling of concept in to operationalization of a public organization. The recommendations of the RMW were:
- BITID should evolve as a center of excellence on infectious and tropical diseases for quality assured research, capacity building, laboratory and clinical services in the hospital and community.
- To serve as a center of excellence, BITID should provide an enabling environment to scientists and all its staff through well governed management that is transparent, and accountable under the stewardship of the Government of Bangladesh.
- A strategic plan (2008-2015) should be prepared to include mission, goal, guiding principles, objectives, purpose, expected outcomes, key indicators, budget and timelines to guide the management of the proposed institute.
- While core support and funding should be provided by the Government of Bangladesh, additional resources should be mobilized to fill the gaps through sustained collaboration and partnerships with national and international academic institutions and funding agencies.
- A one year operational plan is recommended to pave the way for establishing the institutional Mechanisms for transparency, accountability, oversight mechanisms to monitor the progress of Developmental work.
- During 2008, undertake a situation and SWOT analysis including a review of current and ongoing research and initiate a clinico epidemiological and social behavioral research to identify the priorities in research, capacity building and clinical and community based health services relating to tropical and infectious diseases.
- During 2008, all efforts should be made to establish an identity for BITID through establishment of website for information exchange, publication of research and review papers, participation in meetings on tropical infectious diseases.
- To provide a head start to the work of BITID, seed financial support will be required for temporary adequately furnished and equipped premises, and core staff supported by technical and advocacy working groups.
a) To conduct clinical and laboratory research leading to the development of cost effective means to prevent, diagnose and treat locally endemic Tropical and Infectious Diseases (TID).
b)To develop a critical mass of committed human resources and laboratory and clinical facilities dedicated to tackle TID.
c) To provide clinical and diagnostic health care to patients in BITID and its community outreach facilities
d) To promote and sustain productive national and international collaborations to achieve excellence in academic research, service, education and capacity development.
e) To provide evidence to complement relevant national health policy dealings compatible with cost effective, equitable and sustainable development.
f) To advocate the use of evidence based interventions for health promotion, disease prevention and treatment
BITID shall conduct studies principally based on the ‘patient driven’ and ‘policy demanding’ needs. The quality research for clinical and other studies including entomological ones will facilitate development of diagnostic and research laboratory, capacity for IT and statistical analysis as well as quality service. The results of such studies will be generation of scientific evidences that will influence and guide clinical practice and public health measures. Post graduate training and courses in tropical and infectious diseases primarily on the development of tutors will lead to internal capacity building. Such capacity will lead to development of critical mass of health professionals capable to provide quality clinical care. Once core internal capacity is attained BITID will also deliver external capacity building in the country and also in the region.
The vision of BITID has been log framed as a continuum linking Service, Education Research for the wellbeing of the people of Bangladesh and beyond.
Turning the dream in to reality. Its high time to critical evaluation what are achieved and what else are remained. How far it is as par the envisaged Road Map and how far it has been deviated or violated. At the dawn of the Liberation War the Father of the nation and the Founder of Bangladesh declared, ‘The toil this time is for the liberation, the strive for this time is independence’. Let the BITID in the years to come be the translation and transcript of the declaration of the Father of the Nation, ‘Liberation and Independence in the field of Tropical Medicine and Infectious Diseases’. In deed this is the ‘Guiding Beacon’ for the BITID that should never be forgotten.