3.1 1.2 abed obituary lancet

 Founder of BRAC. He was born in Baniachong village, in what is now Bangladesh, on April 27, 1936, and died of complications from glioblastoma in Dhaka, Bangladesh, on Dec 20, 2019, aged 83 years. In the early years after the non-governmental organisation (NGO) BRAC was established in 1972, its Founder and Executive Director Sir Fazle Hasan Abed would travel for days to visit BRAC projects, spending hours speaking to people the agency was trying to assist. “He thought that was his responsibility and the responsibility of the organisation, that it should be working for the poor people and also women and disadvantaged groups”, said Mushtaque Chowdhury, who joined BRAC in 1977 and rose to be its Vice Chairperson before recently retiring. Abed would maintain that focus on the least advantaged, even as BRAC developed into one of the largest NGOs in the world, with programmes spanning public health, economic development, education, agriculture, and disaster relief. There is also a Dhaka-based BRAC University. “He has received many recognitions, but he never thought he should be remembered. He always felt that the work or the need of the people, that’s the legacy that he left for all of us to do”, said Kaosar Afsana, who began working with BRAC in 1992 and is now Professor at BRAC University’s James P Grant School of Public Health. Abed began on a very different career trajectory, studying naval architecture at the University of Glasgow in the UK before transferring to the Chartered Institute of Management Accountants in London. He joined Shell Pakistan after returning home in 1968, and soon became head of the finance division. In November, 1970, a cyclone hit East Pakistan, as the country was then known, killing an estimated 300000 people. Abed mounted a humanitarian response, using his house as a headquarters for meetings and for organising supplies. He was still coordinating relief efforts in March, 1971, when West Pakistan’s military launched attacks in East Pakistan, sparking a war that eventually led to Bangladesh’s independence. After the fighting ended in December, 1971, he returned to a country ravaged by the conflict. Abed, who had moved to London during the conflict, sold a flat he owned there and used the money to provide food and build houses for people as they returned. “I didn’t have much of a vision at that time”, he said in a 2014 interview. “It was just a survival question. How does Bangladesh survive in a country which is devastated, ruined by bombing?” Those early relief efforts guided Abed’s founding of BRAC. Lincoln Chen was working at the Cholera Research Laboratory, now the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), when the cyclone struck and joined Abed with his relief work. “You always knew what he was doing was important and that what he was doing had innovative characteristics, but there was nothing that at any one time suggested its ultimate success. It was persistence and dedication”, said Chen, who is now President of the China Medical Board. Abed “redefined the role of NGOs”, Chowdhury said, with his focus on innovation and evidence gathering. “He would constantly monitor and improve the programmes.” Chen pointed to an early BRAC project to teach Bangladeshi women how to mix oral rehydration fluid and administer it to children with diarrhoea. The effort initially met with limited success, until Abed decided to pay the trainers based on whether mothers remembered how to mix the solution. “He had unprecedented ambitions and encouraged innovations”, Chen said. “I think that’s really how he reached a lot of success.” Known for saying “Small is beautiful, but big is necessary”, Abed oversaw BRAC’s growth, introducing and expanding programmes, including one of the world’s earliest microfinance initiatives, which now serves 7·1 million clients. “One of the things that BRAC has done because of his philosophy is show that you have to work at scale if you really want to change the plight of the people”, said Chowdhury, who is also Professor of Clinical Population and Family Health at the Mailman School of Public Health at Columbia University, New York, USA. Abed oversaw BRAC’s geographical expansion, from operating solely in Bangladesh to running projects in four other Asian countries and in six in sub-Saharan Africa. As BRAC grew, Abed recognised that he could not depend on donors for support. He introduced social enterprises, such as milk processing and fish farming, that now cover a substantial proportion of BRAC’s operating costs. “That reflects his vision, that he would think BRAC will eventually need these resources and to be starting these small industries”, said Shams El Arifeen, the Senior Director of the Maternal and Child Health Division at icddr,b. “I cannot imagine what this country would have been without BRAC.” Abed leaves his wife, Sarwat Abed, daughter, Tamara, son, Shameran, and three grandchildren. Andrew Green