If leaders don't trust local healthcare, why should citizens?

Every time a president, prime minister, minister, senior bureaucrat or influential politician travels abroad for medical care or even routine check-ups, it sends a clear message to the public: our own healthcare system is not good enough, not even for those in charge.
This message is even more concerning now, as Bangladesh faces one of its worst measles outbreaks in recent years.
According to the World Health Organisation, measles transmission has spread across 58 of Bangladesh's 64 districts. Between mid-March and mid-May this year, more than 55,611 suspected cases with nearly 7,416 laboratory-confirmed cases were reported, alongside over 451 suspected measles-related deaths. Around 79 per cent of the cases involved children under five.
UNICEF has warned that problems such as disrupted vaccination programmes, immunity gaps, misinformation, and declining public trust in vaccines have created a risky situation. In response, Bangladesh has started a nationwide emergency measles-rubella vaccination campaign for millions of children. Despite the crisis, most public discussion is focused on blaming for vaccine procurement, stockpiling, and past decisions.
But maybe we are not asking the right question. The real question is: after decades of economic growth, why do Bangladesh's most powerful citizens still not trust the country's healthcare system?
Today, Bangladesh makes medicines that meet international standards. Local pharmaceutical companies export to many countries and are a source of national pride. The country has also made great progress in immunisation over the years. Still, public trust in healthcare is very fragile.
Even wealthy urban families now often seek treatment abroad. Cities like Bangkok, Singapore, Chennai, and Kuala Lumpur have turned into popular healthcare destinations for Bangladesh's middle and upper classes. This is not just about better technology in other countries. It is about trust.
People want predictability, accountability, accurate diagnosis, ethical care, and reliable institutions. When these seem weak at home, people who can afford treatment abroad, decide to move to places of their choice.
Ironically, Bangladesh's medical education system has real strengths. Every year, hundreds of international students, especially from India, Nepal, Bhutan, and several African countries come to Bangladesh to study medicine. Many Bangladeshi doctors also do very well abroad and are recognised in international healthcare systems. This shows the country has strong human potential, academic ability, and a solid foundation in medical education.
Even though Bangladesh produces skilled graduates and attracts foreign medical students, it has not built a healthcare system that consistently earns public trust at home. The challenge involves governance, accountability, infrastructure, ethics, research, patient care standards, and institutional reliability.
The issue becomes even more complex when national leaders themselves continue to support this pattern.
If ministers, MPs, senior officials, and political elites always go abroad for treatment, why should they be in a hurry to fix healthcare at home? Those in power are often shielded from the struggles of regular patients in crowded hospitals, understaffed clinics, and poorly regulated diagnostic centres. No country can build world-class healthcare if its leaders are emotionally and physically disconnected from local institutions.
Malaysia is a good example. Decades ago, its leaders made a clear effort to improve local healthcare, medical education, nursing standards, and specialist training. As a result, Malaysia is a regional medical tourism hub, attracting many foreign patients, including thousands from Bangladesh each year.
Malaysia's leaders kept stressing the need to develop local doctors, nurses, and hospitals rather than rely on foreign healthcare. That national attitude made a difference.
When influential people rely on foreign healthcare, pressure to improve local hospitals drops. The recent measles outbreak shows this bigger institutional weakness. Measles is not just a viral problem; it is a systemic problem. It highlights gaps in public health management, vaccine trust, communication, primary healthcare outreach, and long-term planning.
WHO and UNICEF often say that measles outbreaks happen when immunisation coverage drops below 95 per cent. Even small disruptions can create risky gaps in immunity over time.
To restore public trust and truly reform Bangladesh's healthcare, both leaders and citizens must actively choose and advocate for improving local healthcare system. Leaders must lead by example-using and investing in local healthcare themselves-so that urgent, lasting reform becomes a national priority. Only by committing fully to local healthcare system will leaders inspire citizens' trust and drive national progress.

shafiqrbhuiyan@gmail.com