Medical toxicology is a specialized area of medicine focusing on the diagnosis, management and prevention of poisoning and other adverse health effects caused by medications, occupational and environmental toxins (1), biological agents and snakebite but it is a much more neglected field in some parts of the globe especially in the Asia Pacific region. In Bangladesh, the magnitude of the health problem due to poisoning and snakebite is enormous, in addition to inadequacy of reporting information and awareness (2). Although Dr. Afshari mentioned the important role of poison centers in empowerment of medical toxicology in his editorial (3), no established functional poisoning information centre in Bangladesh exists. Poisoning and snakebite are one of the leading causes of death in Bangladesh (2,4,5). Moreover, there is no specialized hospital or dedicated toxicology units in the tertiary level hospitals.

The immediate plan should be towards establishment of a national poison control center that would serve as a focus point for the development of clinical toxicology training, research and policy making. There is also lack of provision of logistics and drugs for optimum management of poisoning and snakebite victims who are mostly living in poor rural areas (2,4). There should be more focus on training of medical and nursing staff for the proper management of poisoned patients and training of healthcare professionals working at different tiers to prepare and update guidelines for different poisonings and to develop local standardized treatment protocols. Pattern of poisoning varies from country to country. Emphasis should be laid on development of guidelines for locally prevalent poisonings in each region, especially snakebite, organophosphate compound poisoning and methanol poisoning. Providing scholarship for post-graduate training and develop local research agenda and also multicenter trials will be other sensible options to improve medical toxicology (3). One of the most important and essential element for proper management of poisoning is analytical toxicology which is virtually non-existent in least developed countries like Bangladesh. All governments of the region should be urged for improving diagnosis, management and prevention of poisoning considering its enormous public health importance especially among the rural farming communities.