For their outstanding record of promotion of health and human development.
Dr Zafrullah Chowdhury (1941-2023) was a public health activist in Bangladesh, who advanced rural people’s access to medical care through Gonoshasthaya Kendra (GK, The People’s Health Centre). The centre, which was established in 1972 by Chowdhury and his colleagues, has emphasised independent, self-reliant and people-orientated development since its inception.
GK has initiated many innovations. It became the first place outside China to train paramedics seriously. About 160 paramedics now cover a population of 180,000 from the GK centre and ten sub-centres that have been established around the country. They are trained in preventive medicine of all kinds and simple curative medicine. GK also operates a health insurance scheme based on people’s ability to pay. Thanks to GK’s dedicated work, infant and maternal mortality rates in their operational area have fallen to about half of Bangladesh’s national average.
GK has also steadily expanded the scope of its work into additional important areas that affect the lives of the majority of rural-based Bangladeshis: education, nutrition, agriculture, employment generation, the production of basic medicines and women’s emancipation.
We have tried to ... promote the paramedic, the village-level health worker, as the backbone of health care.
Zafrullah Chowdhury, 1992 Laureate
Medical care for rural populations
Gonoshasthaya Kendra (GK, The People's Health Centre) was established in 1972 by Dr Zafrullah Chowdhury and some medical colleagues. From the beginning, GK emphasised independent, self-reliant and people-orientated development. Working originally in the health field it has steadily expanded the scope of its work into additional important 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.
It is, however, in the health field that GK's work has been most innovative. It was the first place outside China to train paramedics seriously. About 160 paramedics now cover a population of 180,000 from the GK centre and ten sub-centres that have been established around the country. They are trained in preventive medicine of all kinds and simple curative medicine and operate a health insurance scheme based on the ability to pay. Thanks to their dedicated work, infant and maternal mortality in the operational area of GK have fallen to about half of Bangladesh's national average.
Improving access to essential medicines
In 1981, GK set up the pharma company and factory Gono Pharmaceuticals (GP) to make essential drugs of the highest quality at low cost. It has been a great success and now supplies an average of 5 per cent of all of Bangladesh's drugs, but as much as 60 per cent of some categories. Just as importantly, the fact that its prices were as much as 60 per cent below those of the multinationals has meant that prices generally have fallen greatly. The factory employs some 400 people. Half of its profits are reinvested, half go to GK's social projects.
Chowdhury was a key adviser to the Bangladesh government in 1982 when it drew up its Essential Drugs Act, proscribing 1,700 dangerous or useless drugs and setting a unique example to other countries of how to control their market for therapeutic drugs. Detailed plans have now been laid for the establishment of an Institute of Health Science that will train doctors specifically in community health and medicine relevant to Bangladesh's needs.
In education and training, GK has an extensive programme. It encompasses literacy for all age groups and a special emphasis on women's development with a range of income-earning initiatives.
GK is controlled by a charitable trust, of which Chowdhury was one of the four trustees. The Trust now employs some 1,500 people full time, with an additional 1,000 part-time. About half of its budget is self-generated. An important principle is that GK never gives away its goods and services for free except to those absolutely in need. They have to be paid for, however cheaply. This explains the relatively high self-sufficiency rate.
