If the healthcare system of a country is dysfunctional, citizens inevitably endure the repercussions, a reality applicable to all nations globally. Consequently, Bangladesh is no exception. Bangladesh is progressing towards digitalization. In this context, several digital healthcare firms have been shown potential. In the past decade, several internet healthcare firms have flourished, aiming to enhance healthcare services and increase access to healthcare.[1] The digital revolution has also reshaped how medicines reach consumers in Bangladesh, with online pharmacies like MedEasy Bangladesh, Tonic, Arrogo, and Practo Bangladesh—among the few licensed platforms approved by the Directorate General of Drug Administration (DGDA)—offering unprecedented convenience.
This change has also resulted in a parallel crisis: a flourishing underground market for prescription pharmaceuticals on social media sites where unregistered sellers provide anything from antibiotics to sedatives without control. Aiming to control this anarchy by substituting modern legislation from the 1980s, the government’s historic Drugs and Cosmetics Act, 2023, has left authorities disorganized due to implementation challenges and changing cyber-tactics. Operating openly on Facebook and WhatsApp, over 1,500 illegal online drug vendors surpass the 14 regulated e-pharmacies permitted under the new regulation as of mid-2024.
Revealing the extent of the problem, a recent national drug authority study revealed a notable seizure of fake pharmaceuticals, including fraudulent drugs connected to growing antibiotic resistance. Health professionals warn that drug-resistant diseases brought on by poorly advertised drugs online account for a significant portion of annual mortality. Furthermore, there have been claims of deaths among patients who got dangerous replacements instead of prescribed drugs found on social media platforms. Though new laws carry severe penalties, including long-term incarceration for individuals engaged in counterfeiting, their execution remains uneven, in part owing to intervention and possible internal complicity inside the regulatory system.[2]
Furthermore, the intended potential of the Act remains constrained by its limited implementation, leaning more toward the idea of centralized digital oversight than practical impact on the ground. Although efforts have been made to introduce traceability measures—such as digital tagging of pharmaceuticals—these initiatives remain largely experimental, leaving the majority of online drug transactions beyond effective monitoring. In parallel, those engaged in illicit trade have adapted quickly, using vague or coded language to promote restricted substances under the guise of wellness or personal care products. This exploitation of regulatory ambiguity disproportionately affects vulnerable groups, particularly the young and economically marginalized, who often turn to informal digital channels for quick solutions to health or body-image concerns. The result is a growing, underregulated market where consumer safety is left to chance, and accountability remains elusive.
Global models point to possible fixes. While India’s 2023 e-pharmacy guidelines[3]—though delayed by court battles—demand strict record-keeping, the revised drug rules of the European Union require that approved internet pharmacies show a verified EU emblem. Approved in May 2024, Bangladesh’s proposed National Digital Health Strategy suggests blockchain-based pharmaceutical monitoring.[4] Blockchain-based pharmaceutical monitoring refers to the use of a secure, decentralized digital ledger that logs every transaction in the pharmaceutical supply chain. This ensures transparency and traceability, helping to detect counterfeit or unauthorized drugs by making data tamper-proof and auditable across all distribution points. But fund shortages have delayed it.[5] First actions are really vital. Although the DGDA recently teamed with Meta to delete 600 illicit drug-selling sites, hundreds more exist. Experts call for AI-driven monitoring to search social media for illegal sales and SMS-based validation systems, allowing customers to verify the licensing status of a pharmacy instantaneously.
Just as important is public awareness. Many still do not know that prevalent in online transactions, buying drugs without a prescription may be fatal. A global issue, antibiotic resistance (ABR) is mostly caused by Bangladesh’s inadequate healthcare standards and combined overuse and abuse of antibiotics.[6] According to a 2024 DGDA research, 68% of antibiotics purchased online were utilized improperly; patients typically stopped dosages early on.[7] Though the human cost is growing, the road ahead is obvious: more interagency collaboration, speedier finalization of e-pharmacy rules, and severe fines for regulatory collusion.
Likewise, the socioeconomic causes of this problem are complicated. In remote communities like Satkhira and Kurigram, where access to healthcare is restricted, people turn more and more to Internet platforms to avoid far-off pharmacies. According to a 2023 World Bank research, 60% of people living in flood-prone areas purchase medications on social media, therefore unintentionally becoming targets for counterfeiters. The appeal of reduced internet prices—often 30–40% less than those of physical stores—overcomes safety issues for low-income families. “I got half-market-priced “Paracetamol” from a WhatsApp vendor when my kid had a fever. Later, the doctor revealed it was glucose powder, recounted Khulna’s mother, Rina Akhter.[8]
Progress is further stalled by critical technological limitations. The agency responsible for monitoring online drug-related activity continues to rely on outdated tools that struggle to detect the evolving language traffickers use to evade oversight. Without the support of advanced technologies capable of interpreting shifting terminology and coded messaging, enforcement efforts remain reactive and fragmented. While some neighboring systems have adopted machine-driven monitoring methods to flag suspicious content in real time, the current model here still leans heavily on manual reporting—often delayed, inconsistent, and easy to bypass. As one official acknowledged in a recent interview, the need for intelligent, adaptive systems is pressing; without them, authorities are always one step behind in an environment that changes by the hour.
Legal uncertainty accentuates the anarchy. The Drugs and Cosmetics Act, 2023 requires licenses for e-pharmacies but does not specify fines for social media sales, therefore enabling unregistered sellers to operate in areas of ambiguity. By contrast, Vietnam’s 2022 regulation penalizes Facebook for running unapproved medicine advertisements,[9] a practice Bangladesh might follow. Concurrently, the delayed implementation of the National Digital Health Strategy—which suggests real-time prescription validation using biometric IDs—leaves critical infrastructure gaps.
The implications stretch far beyond individual well-being. When counterfeit medications infiltrate legitimate supply chains, they not only endanger patients but also threaten the hard-earned reputation of an entire industry. Even a few incidents of compromised quality can shake the trust of global partners, prompting trade disruptions and regulatory backlash. In one recent case, a foreign buyer suspended imports after tracing substandard products back to informal online channels. As one industry insider put it, this is no longer just a matter of consumer protection—it’s about defending the integrity of everything the sector has built over the years.
At the community level, small sparks of progress continue to emerge. Local initiatives have begun empowering citizens—particularly women—to recognize and respond to the threat of counterfeit drugs, offering tools to report suspicious activity through dedicated hotlines. These programs not only raise awareness but also build a sense of agency among those most affected. On another front, a few tech-driven ventures are bridging the gap between regulation and access by partnering with legitimate providers to ensure that people in underserved areas receive safe, approved medications. In these quiet efforts lies a hopeful reminder: that accountability and innovation can work together, even when broader systems falter.
Still, without structural and legislative backing, existing initiatives remain fragmented and lack enforceability. For example, the Directorate General of Drug Administration (DGDA), with approval from the Ministry of Posts and Telecommunications, has introduced an SMS-based verification system that allows consumers to text a pharmacy’s name to 6969 to verify its licensing status.[10] However, the broader regulatory framework remains in limbo, with the proposed E-Pharmacy Rules—designed to mandate digital tracking of prescriptions and patient identifiers—still caught in bureaucratic uncertainty.
Considering these constraints, a phased reform strategy is both realistic and necessary. As an immediate step, the DGDA could enforce mandatory online registration of all e-pharmacies and integrate QR-code verification systems for digital prescriptions to reduce regulatory blind spots. Simultaneously, a specialized digital compliance unit within the Ministry of Health, working in coordination with telecom and fintech sectors, could deploy SMS and app-based tools for drug verification and transaction monitoring. Such scalable and locally adaptable mechanisms would offer immediate regulatory impact while gradually building the infrastructure required for a robust and comprehensive digital pharmaceutical governance system in Bangladesh.
Time is running out. Bangladesh cannot afford regulatory slowness, with 80 million internet users and digital healthcare firms drawing $50 million in funding last year. “Every day without action, another life is gambled with a click,” The decision is obvious: either enable technology to become a conduit for disaster or embrace its promise. Online access to medicine has opened doors for many, but it has also opened floodgates to danger. With counterfeit drugs circulating freely, regulation must move faster than the crime it is chasing. Technology is not the enemy—it is the missing ally in enforcement. Ordinary people should not have to choose between affordability and safety. Bangladesh stands at a crossroads: act decisively now, or watch trust—and lives—slip away.
References:
[1] UNB, ‘Digital Healthcare Startups in Bangladesh: An Overview’ (UNB, 15 August 2021) https://unb.com.bd/category/Business/digital-healthcare-startups-in-bangladesh-an-overview/76049 accessed 13 April 2025
[2] Directorate General of Drug Administration, ‘National Guideline on the Pharmacovigilance System in Bangladesh’ (DGDA, 20 January 2025) https://dgda.gov.bd/sites/default/files/files/dgda.portal.gov.bd/page/51bad071_9750_4ef8_9786_134c53d8971a/2025-01-20-06-05-90d0c1023e89740c315ae02d403cc4fd.pdf accessed 13 April 2025
[3] Spice Route Legal, ‘Regulation of E-Pharmacies in India’ (Spice Route Legal, 27 February 2025) https://spiceroutelegal.com/publications/regulation-of-e-pharmacies-in-india/ accessed 18 April 2025.
[4] Ministry of Health and Family Welfare, ‘Bangladesh Digital Health Strategy 2023–2027’ (Government of the People’s Republic of Bangladesh, 2024) https://dghs.portal.gov.bd/sites/default/files/files/dghs.portal.gov.bd/page/4124d18a_ab99_40e2_8fef_ff4052948739/2024-04-23-07-09-48541d4dd55108137e50961ebcba0477.pdf accessed 18 April 2025.
[5] Ibid.
[6] Iftekhar Ahmed and others, ‘Antimicrobial Resistance in Bangladesh: A Systematic Review’ (2019) 80 International Journal of Infectious Diseases 54 https://doi.org/10.1016/j.ijid.2018.12.017 accessed 13 April 2025
[7] Directorate General of Drug Administration, ‘Research Report on Online Antibiotic Utilisation and Its Contribution to Antimicrobial Resistance in Bangladesh’ (Ministry of Health, Bangladesh 2024) https://www.dgda.gov.bd/research_report_AMR2024 accessed 12 April 2025
[8] World Bank, ‘Path to Transform Bangladesh’s Health System for Better Results’ (World Bank, 2024) https://openknowledge.worldbank.org/server/api/core/bitstreams/afd912e4-4d16-4243-a160-8fbf558506aa/content accessed 12 April 2025.
[9] Vietnam News, ‘Tightening Social Media Advertising’ (30 August 2024) https://vietnamnews.vn/economy/1662074/tightening-social-media-advertising.html accessed 13 April 2025
[10] Directorate General of Health Services, ‘Health Bulletin 2023’ (Ministry of Health and Family Welfare, October 2024) https://dghs.portal.gov.bd/sites/default/files/files/dghs.portal.gov.bd/page/8983ee81_3668_4bc3_887e_c99645bbfce4/2024-10-30-15-17-04fcbbc3747cbf6cc6983a34770666d1.pdf accessed 13 April 2025
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