H C I

Policy Note1:

Executive Context

Artificial Intelligence (AI) is advancing at unprecedented speed. In 2024, global corporate investment in AI rose to US $252 billion, a 45% increase from the previous year. The United States alone accounted for US $109 billion, dwarfing China’s US $9.3 billion and the UK’s US $4.5 billion. Generative AI, a subfield barely recognized a decade ago, attracted nearly US $34 billion in private capital in 2024.

Falling Behind on People

• Education: In FY 2025–26, Bangladesh allocated 1.53% of GDP to education, almost identical to the previous year (1.52%). This is far below UNESCO’s recommended 4–6% and well below the regional average. Bangladesh spent 2.49% of GDP on education in 2016–17, meaning education has been on a declining trend relative to GDP.

• Health: Public spending hovers at ~1% of GDP, one of the lowest in South Asia. By comparison, India spends over 2.1% and the global average is close to 6%. Mental health receives less than 0.5% of the health budget.

Policy Note 2:

Summary

The note argues against the recent proposal to phase out Bangladesh’s community clinics, highlighting them as essential for achieving Universal Health Coverage (UHC). Established in 1998, these clinics provide low-cost, vital primary healthcare to rural populations, and their abolition would undermine major health gains, deepen inequities, and contradict Bangladesh’s development goals.

Drawing lessons from Thailand, Brazil, and Rwanda—countries that strengthened communitybased healthcare as pillars of their UHC success—the paper advocates for revitalizing, not abolishing, community clinics. Key reforms proposed include increasing primary healthcare financing, professionalizing and incentivizing health workers, integrating digital health systems, upgrading infrastructure, and enhancing community ownership.

2.1 Community Clinics in Bangladesh

Established in 1998, community clinics represent a decentralized approach to primary healthcare delivery. Each clinic caters to 6,000 people and is staffed by three key health workers, offering

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