Bangladesh is a “positive deviant” as a result of its progress from being the second poorest country in the world to implementing world-class programs in family planning, immunizations, promotion of oral rehydration therapy for diarrhea, detection and treatment completion for TB, and much more.

The recently published book, 50 Years of Bangladesh: Advances in Health, highlights these and many other achievements and provides an overview of the daunting challenges that must be overcome in the next 50 years if Bangladesh is to achieve universal health coverage and “Health for All.”

The most important of these challenges include major increases in government expenditures for health, building of a strong primary health care system that relies on a professionalized cadre of community health workers that reach every home on a regular basis, catastrophic health insurance for all citizens, innovations in health care delivery within the long-standing culture of reliance on research and evidence, and strong independent civil society engagement by groups such as Bangladesh Health Watch.

A colleague said many years ago, “Bangladesh is to development as Paris is to fashions.” One could also say that Bangladesh is a positive deviant—in a class by itself compared to other low-income countries in the achievements it has made in health and development since its independence in 1971. At that time, it was the second-poorest country in the world (after Upper Volta, now Burkina Faso). Now, Bangladesh is a lower-middle-income country,1 and the government believes that in 20 years, it will become a high-income country.

The reasons for this remarkable progress—from, as Henry Kissinger infamously called it in the early 1970s, “an international basket case,” to a country bustling with empowerment, optimism, and a “basket of innovations”—are complex. But among the important contributors is Bangladesh’s extraordinary achievement in improving the health of its people. …