Acid attacks have fallen sharply but persist: finish the job with survivor-centred enforcement and acid supply control

Diagnosis

Acid violence in Bangladesh is a success story that is not yet finished. As the curated record notes, attacks have "declined sharply but still occurring," with the trend documented in Acid Survivors data. That phrasing carries two policy signals at once. The sharp decline tells us the policy architecture (licensing of acid sales, dedicated legal provisions, and survivor support networks) demonstrably works when applied. The fact that attacks are "still occurring" tells us the residual caseload is the hardest part: scattered incidents, often in places where acid is easy to obtain and where survivors face slow or incomplete medical and legal response.

This matters now precisely because the numbers are low. When a problem shrinks, attention, budget lines, and institutional ownership tend to drain away, and the last cases become the most neglected. A single acid attack inflicts lifelong disfigurement, loss of livelihood, and trauma, so a low count is not a low burden per survivor. The Directorate General of Health Services (DGHS) is the lead responsible body, with the Department of Public Health Engineering as a supporting body, which gives this a clear health and infrastructure spine to build on rather than starting from scratch. The current quantitative state is not recorded in the registry, which is itself a gap: without a live indicator, decline can quietly reverse before anyone notices.

Recommended actions

1. Tighten the acid supply chain at the point of sale. Owner: Department of Public Health Engineering (supporting body) working with the licensing administration. Mechanism: enforce and audit acid-sale licensing so that unlicensed and informal sales are detected and closed, treating loose availability as the upstream cause. Observable signal: a falling share of seized or surveyed acid traced to unlicensed sellers, and licence audits completed on a published schedule.
2. Guarantee a fast, standardised survivor care pathway. Owner: DGHS. Mechanism: a DGHS circular designating burn-treatment referral hospitals, a fixed first-response protocol for acid burns, and a named focal point in each designated facility, so that any survivor reaches specialised care without delay. Observable signal: time from incident to specialised burn care shortens, and every designated facility reports a trained focal contact.
3. Restore a live national indicator. Owner: DGHS. Mechanism: a standing reporting line that ingests Acid Survivors data plus hospital admissions into a single tracked series, replacing the current null current_state with a maintained figure. Observable signal: a regularly updated case count exists and is reviewed, so any uptick triggers response rather than passing unnoticed.
4. Protect the support and rehabilitation network as caseloads fall. Owner: DGHS coordinating with survivor-support providers. Mechanism: a protected budget line for survivor rehabilitation, surgical follow-up, and reintegration, ring-fenced so it is not cut as incident counts decline. Observable signal: continuity of survivor services year over year regardless of the annual case number.

Sequencing (first 12 months)

Begin with the indicator (action 3) and the care-pathway circular (action 2), because both are administrative actions DGHS can issue directly and both create the visibility and readiness that everything else depends on. A live series tells you where residual attacks cluster; the circular ensures that when an attack happens, the survivor is handled correctly from hour one. These two unlock the targeting for action 1: supply-side enforcement is most effective when it is aimed at the localities the indicator flags, rather than applied uniformly. Action 4, the protected budget line, should be locked in within the same year so that the support network is not eroded while the other measures take hold.

Risks and constraints

The binding constraint is attention decay: with attacks already low, sustaining budget and enforcement is politically harder than launching a campaign against a visible crisis. A second constraint is coordination, since the lead sits with DGHS (a health body) while supply control runs through the Department of Public Health Engineering and licensing authorities, so ownership can fall between bodies. A third is data: with current_state unrecorded, decision-makers may assume the problem is solved and withdraw resources prematurely. Enforcement of acid-sale licensing also competes for scarce inspection capacity.

Bottom line

Acid attacks have declined sharply but still occur, which means the task is to finish a near-win, not fight a new fire. DGHS should hold the line with a live case indicator, a guaranteed survivor care pathway, tighter acid-sale licensing, and a protected support budget, so the residual cases fall toward zero instead of quietly creeping back.