Zafrullah Chowdhury: The People's Doctor Who Rebuilt Healthcare for the Poor

Few Bangladeshis have repaid their country's gift of independence as concretely as Dr Zafrullah Chowdhury. When Bangladesh emerged from war in 1971, its villages had almost no doctors, its drug market belonged to foreign companies, and its rural poor — the overwhelming majority — were expected to sicken and die quietly. Chowdhury spent the next fifty years refusing that settlement. He built Gonoshasthaya Kendra (GK), the "People's Health Centre", trained village women to do work the medical establishment insisted only doctors could do, wrote the 1982 National Drug Policy that broke the multinational drug companies' grip and seeded today's pharmaceutical industry, founded a drug company and a university, and argued with every government that held power in between. The Lancet, in its obituary, called him a "surgeon, public health activist, and champion of health equity". Bangladeshis had a shorter name for him: the people's doctor. This is the record of what he did — and it is also, necessarily, a word of thanks.

Early life and education

Zafrullah Chowdhury was born on 27 December 1941 at Koyepara village in Raozan upazila, Chittagong district, the eldest of ten children of Humayun Morshed Chowdhury, a police officer, and Hasina Begum Chowdhury. Part of his schooling was in Calcutta, and he later admitted — with the honesty that became his trademark — that he grew up with "hardly any rural connections" at all. He passed his matriculation from Nabakumar Institution in Dhaka and his intermediate examinations from Dhaka College, then entered Dhaka Medical College, where he took his MBBS in 1964. As a student he was elected general secretary of the Dhaka Medical College Students' Union and began, early, the habit of a lifetime: as The Lancet recorded, earning his degree "did not stop him from exposing corruption within the institution".

He went on to London for postgraduate surgical training — the FRCS course in general and vascular surgery. He was near the end of the four-year course when, in March 1971, the Pakistan Army launched its crackdown on Bengal. Chowdhury organised among expatriate Bengali doctors in Britain, served as general secretary of their Bangladesh Medical Association, raised money and medicine for the government-in-exile, and at a London rally publicly tore up his Pakistani passport. Then, as Jahanara Imam recorded in Ekattorer Dinguli, he skipped his FRCS final examination — the credential that would have made his career — and flew to India to join the war.

The Liberation War and the Bangladesh Field Hospital

In June 1971 Chowdhury and his colleague Dr MA Mobin reached Agartala in Tripura. Near Melaghar, close to the Sector 2 headquarters of Major Khaled Mosharraf, they set to work at a thatched, bamboo structure at Motigarh that became the Bangladesh Field Hospital, bringing with them surgical instruments and medicines collected in London. After fighting as a guerrilla in the war's early weeks, Chowdhury concentrated on the hospital, and what happened there shaped everything that followed. The hospital grew to 480 beds, served by just five Bangladeshi doctors — and by a large number of local women, most with no medical background whatsoever, who were trained within days to nurse the wounded and the sick. It treated injured freedom fighters and refugees for the rest of the Liberation War.

The lesson he drew was heretical for its time: if untrained village women could keep a war hospital running, then rural Bangladesh did not need to wait for doctors who would never come. Healthcare could be carried to the poor by the poor themselves, properly trained. The field hospital was not only his war service; it was the prototype of his life's work.

Gonoshasthaya Kendra: a health service built around the poor

After independence the field-hospital team moved to Savar, outside Dhaka, and in 1972 founded Gonoshasthaya Kendra as a public charitable trust, with the support of Bangabandhu Sheikh Mujibur Rahman. Chowdhury took the unglamorous title of projects coordinator — and kept it for fifty years. GK's founding idea was the paramedic model: young rural women, most with only secondary schooling, trained to deliver preventive, primary and basic curative care village by village, each responsible for roughly 3,000 people. The model deliberately recruited women — a positive discrimination GK practised from its inception — and put them to work not only as health workers but, in time, as drivers, mechanics and technicians, at a period when such sights were radical enough to be photographed on the Dhaka–Aricha highway.

The world noticed quickly. In September 1975 The Lancet published his co-authored study "Tubectomy by Paraprofessional Surgeons in Rural Bangladesh", evidence that trained paraprofessionals could safely perform work reserved elsewhere for surgeons; his obituarists describe it as the journal's first cover article from the Indian subcontinent. In 1977 the Government of Bangladesh adopted the paramedic model nationally. Four years earlier, in 1973, GK had introduced Bangladesh's first rural health insurance system, with premiums graded by ability to pay, so that the poorest were covered by the contributions of the better-off. Around the clinics grew an entire development ecosystem: 187 rural schools, a technical college, an institute of health sciences, hospitals in Savar and Dhaka, and one of the country's largest low-cost dialysis centres.

GK's influence also ran outward. Its experience fed into the global primary-health-care movement, and in December 2000 Chowdhury brought the first People's Health Assembly to Savar — the gathering that founded the People's Health Movement. David Legge of La Trobe University, a founding member of that movement, recalled that Chowdhury was "absolutely leading in proselytising for the idea" of the Assembly. A village health project founded by five doctors had become a node in a worldwide argument about whose health counts.

The 1982 National Drug Policy

If GK was his gift to the villages, the National Drug Policy was his gift to the whole country. In the early 1980s Bangladesh's medicine market — some 4,000 products, many of them useless, irrational or dangerous — was dominated by multinational companies, while essential drugs were scarce and dear. Chowdhury had argued the case for an essential-drugs policy to Bangabandhu, and had declined President Ziaur Rahman's offer of a cabinet post, explaining in a four-page letter that he could not serve alongside an anti-liberation figure. Under President Hussain Muhammad Ershad, the chance came: an eight-member expert committee was formed in April 1982, with Chowdhury as its chief adviser and driving force.

The committee reviewed every product on the market against sixteen criteria. The policy it produced adopted a list of just 150 essential drugs, with 100 more supplementary medicines, and cancelled the registration of 1,742 products — the figure given by scholarly reviews of the policy — while stopping imports of medicines that could be made at home. The multinational companies fought hard against it, and Chowdhury received threats; the policy stood. It is now widely credited with creating the modern Bangladeshi pharmaceutical industry, which grew from a import-dependent market into an industry that supplies the overwhelming majority of the country's needs and exports to the world. Chowdhury told the story himself in The Politics of Essential Drugs: The Making of a Successful Health Strategy. Anwar Fazal, founder of Health Action International, gave the policy's author his due in The Lancet: "He pioneered the global phenomenon that is essential drugs."

A pharmaceutical company and a people's university

Chowdhury did not believe in policy without production. In 1981 GK founded Gonoshasthaya Pharmaceuticals Limited to manufacture essential medicines cheaply at scale — proof, in tablet form, that quality drugs need not be expensive. Education followed the same logic. GK's concept of a university was framed in 1994, and on 14 July 1998 the trust established Gono Bishwabidyalay — the "People's University" — at Nolam, Mirzanagar, Savar: a not-for-profit institution joining health sciences to social sciences, agriculture and veterinary medicine, charging fees aimed at families other private universities ignore, and still the only private university in Bangladesh whose students elect their own central union.

The conscience that would not keep quiet

Chowdhury never accepted that gratitude for past service should buy silence in the present. He criticised governments of every stripe — over health policy, elections, prices and rights — and in October 2018, aged seventy-six, he helped form the Jatiya Oikya Front, the opposition alliance led by Dr Kamal Hossain; he sat on its steering committee and headed the panel that drafted its election manifesto. The response was swift: remarks he made about the army chief on a television talk show were converted into a treason case, and two further cases in Ashulia accused him and GK officials of attempted land-grabbing and extortion, from which the High Court granted him anticipatory bail. Fairness requires the other entry in the ledger too: he was criticised in his lifetime for working with the military governments of Zia and Ershad — the route by which his drug policy became law. He seems to have regarded such compromises as the price of getting things done for people who could not wait.

The patient as advocate

In his last years Chowdhury campaigned from the receiving end of the system he had built. He lived with chronic kidney disease, on dialysis three days a week, in a country where dialysis at private rates ruins families; GK's own dialysis centre was treating more than 250 patients a day at a fraction of those rates, and he pressed for universal access to low-cost dialysis. In November 2019 he demanded amendment of the Transplantation of Human Organs Act: of roughly 10,000 Bangladeshis needing a kidney transplant each year, he pointed out, only some 200 to 250 could receive one, because the law allowed living donation only by close relatives — a restriction that quietly fed an illegal organ trade. He attended a High Court hearing in person to argue that any healthy volunteer should be allowed to donate under proper safeguards; weeks later, the Court directed the government to amend the law to admit "emotional donors".

The pandemic brought his last public battle, and it did not end in victory. In 2020 a GK team led by microbiologist Dr Bijon Kumar Sil developed the "GR Covid-19 Rapid Dot Blot" kit, intended to test for a few hundred taka; Chowdhury, who himself contracted COVID-19, championed it and accused the regulators of deadly delay. But when Bangabandhu Sheikh Mujib Medical University trialled the antibody kit on 509 samples, it detected infection in only 11 percent of cases in the first week and 40 percent in the second, and could not identify current infection reliably; the drug administration never approved it for mass use, a verdict GK disputed to the end. The episode belongs in his record unsmoothed: the same impatience that had built GK in months rather than years here ran ahead of the evidence. It does not diminish the life's work, but it was characteristic of the man — he would rather be wrong trying to save the poor money than be silent.

Death and the nation's farewell

Chowdhury was admitted on 5 April 2023 to the Gonoshasthaya Nagar Hospital in Dhaka — a hospital he himself had founded — and placed on life support on 10 April. He died on 11 April 2023, aged eighty-one, of complications of his kidney disease. Two days later his body lay in state at the Central Shaheed Minar, where thousands of ordinary people — the constituency he had served for five decades — filed past to pay their respects. On 14 April, after funeral prayers at Savar, he was buried in front of Suchana Bhaban on the Gonoshasthaya Kendra premises, in the ground where his work began. At a memorial meeting later that month, his fellow campaigners of the health movement agreed on the tribute he would have wanted: that continuing the fight for a pro-people healthcare system would be the fitting memorial.

Honours, legacy and a debt acknowledged

The honours came early and never really stopped. In 1977, in the very first year of the award, he received Bangladesh's highest civilian honour, the Independence Day Award, for his work in population control. The Ramon Magsaysay Award followed in 1985, its citation praising him "for his engineering of Bangladesh's new drug policy, eliminating unnecessary pharmaceuticals, and making comprehensive medical care more available to ordinary citizens". In 1992 he and Gonoshasthaya Kendra received the Right Livelihood Award in Sweden. There were other laurels — a Swedish Youth Peace Prize, a Canadian doctorate of humanitarian service, a place among the University of California, Berkeley's International Public Health Heroes — but the most remarkable honour was the last. In March 2026 the government named him, posthumously, for a second Independence Award, this time for social service, alongside a separate award to Gonoshasthaya Kendra itself. No Bangladeshi had ever been given the award twice, and the rules forbade it; the Cabinet Division amended them so that a second award could be made in a different field after twenty-five years. On 16 April 2026 his son, Barish Hasan Chowdhury, received the medal from the Prime Minister on his father's behalf.

His peers abroad delivered their verdict in The Lancet. Lincoln Chen, president emeritus of the China Medical Board, called him "a pioneer in primary health care and health equity and health justice for the poor". Beverley Snell of Health Action International said: "There was absolutely no end to what he would take on. If there was injustice anywhere, he would be there." David Legge concluded that he leaves a legacy of "honesty, speaking truth to power, and a commitment to a better world, which we can all learn from". Bangladesh's own emeritus professor Serajul Islam Choudhury judged his contribution simply "unique".

What he leaves behind is not only a set of institutions — a health centre that became a movement, a drug policy that became an industry, a university, a dialysis ward full of patients who would otherwise be dead or destitute. It is a proof, demonstrated over fifty years, that a poor country is not a helpless one: that village women can be its doctors, that its medicines can be made at home, and that one stubborn, incorruptible citizen can bend the state toward its poorest people. Bangladesh does not produce such citizens often. When it does, gratitude is not sentiment; it is accuracy. Zafrullah Chowdhury earned his.