Don't let Shastho Batayan wither away

Governments in developing economies routinely contract private vendors to deliver public services—a pragmatic response to capacity gaps in the state apparatus. As the unravelling of Bangladesh's national teleconsultation service, Shastho Batayan, demonstrates, these arrangements are only as robust as the state's willingness to manage them: to pay on time, renew contracts before they lapse, and treat a private operator running an essential service as a partner with obligations on both sides.

Since its launch in 2015, the 16263 health hotline has been a triumph of public policy. By providing free, round-the-clock medical advice, the service has handled 2.72 crore calls until June 24 this year, emerging as a lifeline for rural and underserved populations. During the Covid pandemic alone, it fielded about 1.1 crore calls, keeping minor cases out of overwhelmed hospitals. It represents precisely the kind of scalable, low-cost digital intervention that resource-constrained nations desperately need. Today, however, this vital service is facing sheer bureaucratic inertia. The service’s private operator, Synesis IT, has not been paid by the state for 22 months, resulting in arrears of roughly Tk 14 crore. Forced to rely on bank loans to meet payroll, the provider has predictably slashed its workforce by half. A hotline that managed up to 6,000 inquiries a day is now leaving many vulnerable citizens unanswered.

The roots of this crisis lie in a funding structure that was always fragile. Shastho Batayan operated under a sector-wide health programme whose tenure expired in June 2024. The interim government's decision to scrap the proposed successor programme in March 2025 created a funding vacuum—one that nobody moved quickly enough to fill. Meanwhile, the operator's contract expired in April, and a proposed short-term extension has since been languishing on the health minister’s desk. Compounding the problem, the Directorate General of Health Services has proposed a mere six-month extension, completely ignoring the reality that public tendering for a replacement contract routinely takes up to 10 months. Then again, approving the extension today would not solve the problem; it would merely defer it. Two months have already been lost, leaving barely four months of operation before the same crisis resurfaces.

This is nothing more than a governance failure with direct costs: patients going unadvised, a private operator pushed to the edge of insolvency, and a proven public health service operating at half its capacity only because papers were left unsigned. Forcing a private contractor to absorb the state’s financial obligations undermines collaborative services. The government should not shun private partners who are working on vital health projects. The cost of running a telehealth call centre is a fraction of the financial burden incurred when citizens, denied timely medical advice, eventually arrive at overcrowded and heavily subsidised state hospitals. The authorities must act with the urgency this crisis warrants. The health ministry must clear the outstanding arrears and grant a realistic extension to the current operator to ensure continuity of care while a new tender is processed. A service reaching millions of users should not be allowed to drift into contractual limbo.