Dr Zafrullah Chowdhury – the indefatigable optimist (1941 to 2023)
13 April, 2023
Dr Zafrullah Chowdhury passed away in the morning of 11 April, 2023. With that the world lost one of the foremost champions of peoples health rights and primary healthcare that the world hasever known. From when he was a medical student in the early 60s to his final days, he worked tirelessly for extending health and health care to the people and for championing the cause of health rights of the poor and the most marginalized.
Dr Zafrullah was born in 27 December, 1941. He grew up in Dhaka, completing his MBBS in 1964 from University of Dhaka and then left for England where he trained to be a general and vascular surgeon from 1965 to 1971. He passed the primary FRCS examination. But before he could sit for the final examination, the war for liberation of Bangladesh broke out. He rushed back and joined the liberation effort, initially as a fighter and later by setting up a field hospital for freedom fighters and refugees at the border of Tripura state of India. This was a makeshift 480–
bed hospital run by five Bangladeshi doctors, few medical students and a large number of women volunteers who were locally recruited and trained on the job to serve as nurses and paramedics.
After the war, the makeshift hospital was relocated to Savar – a rural location about 3 kilometres from the Dhaka. This became the famed Gonoshasthaya Kendra (GK), which translates to Peoples Health Centre.
From 1972, the year of its establishment, GK has been the centre of a large number of innovations that paved the way for accepting primary health care as the key strategy for Health for All. The experience of GK became the basis of one of the main working papers on which the Alma Ata Declaration of the World Health Organization was framed. One of GK’s great achievements was to demonstrate the range of care that could be provided by good paramedical training and the
crucial role they play in the delivery of affordable primary health care. One of the early papers which drew attention was their ability to expand reproductive health care, including surgicalsterilization access, through trained paramedics.
Another innovation of theirs was a community–based insurance scheme. They have now expanded
to two major hospitals and over 13 health centres. All of these work on a cross–subsidy model where the same quality of care is provided to all, but there are six different rates that are charged based on the ability to pay. Their services now reach over one million people. They are also leading providers of services amongst the most marginalised like the Rohingya tribals. GK is now also a university, training hundreds of health professionals in all the different categories every year. Recognising the inter–sectoral nature of health, GK, under the leadership of “Zafar Bhai”— as hewas popularly known – also steadily expanded the scope of its work into areas that affect the lives of the majority of rural–based Bangladeshis: education, nutrition, agriculture, employment generation, production of basic medicines and women’s emancipation. They developed self– reliant, affordable, people centred models in all these areas.
It was not only in primary health care that GK provided world leadership. In 1982, under the guidance of Zafrullah, Bangladesh amazed the world by adopting a historic National Drug Policy that identified 150 essential medicines, as well as banned over 1600 unessential and irrational medicines. This revolutionised the struggle for access to essential medicines, inspiring health activists across all countries. This story is well captured in his book: “The Politics of Essential
Drugs: The Making of a Successful Health Strategy: Lessons from Bangladesh” (Zed Books, UK, 1995).
But this was not the only challenge he posed to Big Pharma. Another remarkable direction that Zafarullah gave to Bangladesh, was the setting up of GK Pharmaceuticals which manufactured many basic essential medicines, intravenous fluids and antibiotics at very affordable rates.
Though an unquestioned leader of national liberation and health sovereignty and self–reliance, Zafrullah was also an internationalist. An early paper, published in 1977 was on Research as a form of Colonization. Unity and solidarity of developing nations in their fight against the domination of the global north was a major concern of his. He was a founder member of Health Action International– Asia Pacific Region. In year 2000, he led the organization of a Peoples Health Assembly to be hosted at Savar, Dhaka. As a part of this, he toured many countries, meeting
people’s movements, inspiring them to make this a global mobilizational event. It was the tremendous success of this mobilization that brought back the Alma Ata Declaration into the public discourse and challenged the hegemony of neo–liberal health sector reforms. To us, in the People’s Health Movement, it was the moment and context of creation of our movement as the foremost champion of health rights, a movement working across regions and countries to make “Health for
All” a reality.
In 1977, he received the highest civilian honour of the Bangladesh government, the Independence Award. In 1985, he was awarded the Ramon Magsaysay Award from the Philippines. In 1992, he received the Right Livelihood Award from Sweden. Most of these awards were shared with GK, the organization he had founded. He also received the International Health Hero award of the University of Berkeley in the United States, and the Ahmed Sharif Memorial Award of Banglades.
Zafrullah Chowdhury was an incorrigible optimist. Expressing his feelings after receiving the Ramon Magsaysay Award, he wrote: ‚Where is the conscience of this world today? Where is our humanity? Is humanity asleep? No! People all over the world will rise again very soon against exploitation and imperialism, to end human misery.‘ Everyone who knew him have anecdotes to relate. Almost all of them a mixture of overflow of his passion, anger at injustice, mixed with wry
humour and a ready laugh.
At the age of 81, Zafrullah remained active and tireless, despite being in chronic renal failure and having survived a near fatal attack of Covid–19. GK was still in expansion with a new hospital coming up in Dhaka and a major program of health relief ongoing in Cox’s Bazaar. One of their recent and most remarkable innovations was the establishment of a modern state–of–the–art haemodialysis centre attending to over 300 patients a day. Services are offered at very low rates
that even the poor can afford and with cross–subsidised free care for the poorest. Zafrullah himself was treated with regular haemodialysis in the same centre. But all of this did not stop him from making his field visits and sharing in the responsibilities of management. Even at this age, his energy, his delight in what each day brings, and his drive to push ahead despite all the odds, was incredible.
Sleep well friend and comrade. Rest in peace. Your memory will continue to inspire us and many generations to come. Our heartfelt condolences to his wife, his friends and the entire GK family.