mortality in 2008. Prevalence of HIV in Bangladesh, as a percentage of people aged 15–49 years, is below 0.1 per cent (2012). While there was relatively little decline in estimated incidence of tuberculosis (TB) in the period 1990–2012, estimated mortality (when mortality data excludes cases comorbid with HIV) has been falling steadily since 1994 and has decreased in total by more than a quarter. The number of confirmed cases of malaria fell by more than a third in the period 2006–12, while confirmed deaths from the disease saw a dramatic decrease from 508 in 2006 to 11 in 2012. The most commonly diagnosed mental illness in Bangladesh is schizophrenia. Health systems: In 2012 government expenditure on health was 1.2 per cent of GDP, equivalent to US$9 per capita. In 2011 there were 36 doctors, and 22 nurses and midwives per 100,000 people. Additionally, in the period 2007–11, 31 per cent of births were attended by qualified health staff and in 2011, 93 per cent of oneyear olds were immunised with one dose of measles. In 2012 the UN estimated that 85 per cent of the people were using an B a n g l a d e s h improved drinking water source and 57 per cent had access to adequate sanitation facilities. Bangladesh has maintained a high level of immunisation coverage against diseases such as diphtheria, whooping cough, tetanus and measles, with 93 per cent of oneyear olds in 2013 immunised with one dose of measles. In 2007 the country had six pharmaceutical personnel per 100,000 people. Public and private health facilities are scarce. BRAC, the country’s largest non-governmental organisation (NGO), fulfils a significant proportion of the country’s health care delivery. The Bangladesh Medical College and Hospital, United Hospital and Kumudini Hospital are among the largest private hospitals in Bangladesh. Outside of Dhaka, health facilities become even scarcer. The country nonetheless has a burgeoning pharmaceutical manufacturing industry, which, in addition to fulfilling most of the local demand, also caters for international markets. The government has predicted that the industry should surpass the ready-made garment industry in ten to 15 years’ time in terms of export earnings (2011). The most recent act relating to mental health in Bangladesh is the Lunacy Act 1912. A draft version of a new Mental Health Act was drawn up in 2006, although it has yet to be enacted. Health MDGs: The Millennium Development Goals (MDGs) mature in 2015, but monitoring of progress is ongoing due to the time it takes to collect and analyse data from each country. Commonwealth Health Partnerships 2015 143 Under-five mortality 150 120 90 60 1990 1995 2000 2005 2010 2015 Under-five mortality per 1,000 live births 2015 MDG 4 target 30 Mortality by cause of death (% of all deaths), 2012 Communicable diseases, Injuries maternal, perinatal and nutritional conditions Non-communicable diseases Tuberculosis: Incidence and mortality 1990 2000 2010 Mortality excluding cases comorbid with HIV (per100,000 people) Incidence of tuberculosis (per 100,000 people) – including cases comorbid with HIV 250 200 150 100 50 Life expectancy 1980 1990 2000 2013 Life expectancy Life expectancy in years 80 70 60 50
Commonwealth Health Partnerships 2015
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