As elsewhere in the world, Bangladesh's health sector has also been facing an unprecedented challenge from the covid-19 pandemic since March when the country's first death from the virus was reported. The already rickety health delivery system soon found its resources stretched to their limit to meet the emergencies created by the sudden onset of the pandemic.
The desperate state of healthcare system in the face of the pandemic should be an eye-opener for the government and propel it to mobilise all necessary resources so that it can meet emergencies of this kind. With the next fiscal year (FY 2020-21) just round the corner, it is only expected that this time the ADP (Annual Development Programme) for health would receive a boost in terms of fund allocation. However, what could be gathered from sources in the planning commission, the prospects do not look very bright. If anything, there may be a slight increase of about TK 8.0 billion over the current ADP worth of Tk 122.36 billion. Whatever the case, it is hoped that the government would realize the gravity of the situation and arrange for efficient allocations in the next ADP for health that are responsive to the emerging needs.
It could be learnt that the poor allocation in the development budget for the health and family welfare ministry is ascribable largely to its lack of capacity to utilise funds. This has also been shown as the reason why the health ministry is apparently so shy about asking for more funds from the government. The records in the relevant government body monitoring project implementation also revealed that until March, the health services division could spend only 37 per cent of the fund allocated for it in the current fiscal.
Unfortunate though it is, still it cannot be accepted as a reasonable ground for not channelling adequate financial resources to an all-important sector like the health. And the miserable condition of the existing health infrastructure and service delivery system that the pandemic has caused to bring to the public glare should have made the policymakers see reason and think of bringing about necessary changes in the present healthcare delivery system. Surely, generous budgetary allocations by themselves would not be enough if project-implementation capacity is not radically improved.
Therefore, the primary consideration should be a readiness in the government to marshal adequate resources for the health sector so that intensive capacity building measures for the health service personnel as well as a drive to modernise the prevailing health infrastructure could be undertaken forthwith. With only five per cent of the national budget dedicated to health, which comes to around two per cent of the GDP, Bangladesh falls behind most of its South and Southeast Asian neighbours so far as per capita health expenditure is concerned. A WHO study shows that with its per capita health expenditure at S$32, Bangladesh trails far behind even Maldives at US$118. And to think that 65 per cent of this US$32, the consumers pay from their own pocket! It is time for a radical rethink of how we want to run our healthcare system so it can meet the needs of the time.
