The government should increase budgetary allocation for the health sector to face the challenges of ensuring proper healthcare for country’s people as the coronavirus pandemic has revealed a ‘poor’ healthcare capacity in the country, experts said.
They also said the government also has to properly utilize the resources and free the health sector from corruption to achieve Universal Health Coverage (UHC) both in the rural and urban areas.“The health budget has both positive and negative sides. The allocation of Tk 100 billion as a lump sum to face COVID-19 challenges, allocation of Tk 1 billion for research of health sector development are very positive sides of the proposed health budget,” said Professor Dr. Syed Abdul Hamid, former director of Institute of Health Economics (IHE) of Dhaka University.
Welcoming the government’s proposal of reducing import duty on essential raw materials for locally producing autoclave machines used for sterilising medical instruments and proposal of reducing prices of the COVID-19 test kit, PPE, face mask and medicine for Covid-19 treatment, he also termed these decisions as another positive side of the health budget.
Finance Minister AHM Mustafa Kamal proposed to allocate Tk 292.47 billion for the Health Services Division, and the Health Education and Family Welfare Division. A total of Tk 257.33 billion was proposed for the health sector in the 2019-20 fiscal year.
Some 13 ministries and divisions are implementing programmes related to health and family welfare. The allocation for this purpose in FY 2020-21 is Tk 410.27 billion, which is 1.3 per cent of GDP and 7.2 per cent of the total budget allocations, Dr. Syed Abdul Hamid added.
Tk 228.84 billion was allocated for the health services division for 2020-2021 fiscal year, including Tk 128.30 billion for operation and Tk 100.54 billion for development. An amount of Tk 63.63 billion was allocated for medical education division, including Tk 39.17 billion for operation and Tk 24.46 billion for development.
“To combat the COVID-19 pandemic, we are implementing different programs involving Tk 55 billion under the Health Services Division. The government will do whatever is required to be done to address the pandemic. To meet emergency requirements, I propose to allocate Tk 10,000 crore (Tk 100 billion) as a lump sum amount,” AHM Mustafa Kamal said in his budget speech.He said two projects have been taken to fight the Covid-19 pandemic. One is the ‘COVID-19 Emergency Response and Pandemic Preparedness Project’ at a cost of Tk 11.27 billion with financial assistance from the World Bank. The other one is the ‘COVID-19 Response Emergency Assistance’ of Tk 13.66 billion with financial assistance from the Asian Development Bank.
The Finance Minister also proposed a Tk 1 billion "Integrated Health-Science Research and Development Fund" for development of research in health-education, and science and technology.
With the Covid-19 pandemic posing the biggest challenge to public health in this generation, spending more on healthcare has been the call from economists and medical experts.
The share of health budget remains below one per cent of the Gross Domestic Product -- only 0.92 per cent, lowest compared to its peers in South Asia. The country's public spending on healthcare has been hovering around 1 per cent of the GDP for many years, although the World Health Organization recommends it to be at least 5 per cent.
Bangladesh's healthcare system has already been struggling with the increasing burden of diseases, low coverage and an inadequate national budget. As the size of the budget increased every year, the allocation for the health sector rose too. But in terms of the percentage of the total budget, it remained around 5 per cent over the years.
“There is little increase in the budget for non-COVID related health services as the budget for health and family welfare ministry is Tk 292.47 billion, which includes two COVID-19 related projects of Tk 24.93 billion. If we deduct the amount of the two projects, the core health budget stands at only Tk 267.33 billion---which is only around 10 billion higher than the health budget of the outgoing fiscal year. So, the proposed health budget for fiscal 2020-21 is not adequate,” Syed Abdul Hamid said.
In his reaction to the proposed health budget, Professor Dr Kanak Kanti Barua, vice-chancellor of Bangabandhu Sheikh Mujib Medical University (BSMMU), told the Daily Sun the proposed health budget is not adequate to ensure proper health services for people of Bangladesh.
“We expected that the health budget would get adequate but it didn’t happen. The increase in the health budget for fiscal 2020-21 than the outgoing fiscal year is not enough as a large portion of the health budget is spent in salary and allowances of manpower of the health sector,” he added.
Dr Ehteshamul Haque Chowdhury, secretary-general of Bangladesh Medical Association (BMA), told the Daily Sun that “the proposed health budget is not enough to cater to the needs of the health sector. The allocation didn’t increase in proportion with the size of the national budget.”
Referring to the recommendations of the World Health Organisation (WHO) for allocating a minimum 5 per cent of the GDP for the health sector, he said sadly the country’s health budget was 4.9 per cent of the total budget in last fiscal year and it is only 5.14 per cent for fiscal 2020-21, which is not ideal to ensure proper health services for huge people.
Ehteshamul Haque Chowdhury said setting up more medical colleges and hospitals and necessary logistics support to run the hospitals like medical equipment, skilled manpower and medicine was a must, but this requires a significant increase in the budgetary allocation.
He also emphasized on making the health sector free from corruption and ensuring proper utilization of the allocated funds for the health sector.
Mentioning that the proposed health budget is 5.14 per cent of the total national budget, Syed Abdul Hamid said there is no notable change in the proposed health budget for 2020-21 as it was 4.91 per cent of the total national budget in the current FY 2019-20.