Rebuild health sector to take challenges

Public health experts have urged the government to raise allocation for health sector in the next budget for improving the healthcare infrastructure in the country amidst the ongoing coronavirus pandemic.
“Covid-19 pandemic has exposed the loopholes in the healthcare system and highlighted the need for a major infrastructure boost. So, a higher budgetary allocation is necessary to strengthen healthcare as well as long-term response to the virus,” Ehteshamul Huq Choudhury, General Secretary of the Bangladesh Medical Association (BMA).
He said, “We need huge investment to improve medical infrastructure and ensure universal healthcare facilities for all. Considering the fact, the government should go for a phase increase in health expenditure under a long-term vision.
Besides, he said, the authorities must ensure timely disbursement and proper utilization of budgetary fund and accountability of the concerned officials in case of misuse and pilferage of public funds in the procurement process.”
The BMA leader also mentioned that the government should not only build many hospital buildings in the name of boosting health infrastructure, but also needs to ensure availability of doctors and nurses to the healthcare sector.
Ehteshamul Huq said, the next budget should also have a separate fund for research and development to fight against the emerging diseases in the country. If we can ensure proper research facility here then local companies can develop and produce Covid vaccine. “We have many world- class pharmaceuticals companies”.  
“In Bangladesh, the percentage of healthcare budget to GDP was always below one per cent in the last fifteen years. Even, the healthcare expenditure to GDP has been consistently lower than other South Asian countries. That indicates the lesser strategic priority of Bangladesh for healthcare sector compared to other countries in South Asian region as well,” Muzaherul Huq, former Southeast Asia Region adviser at the World Health Organization (WHO) told The New Nation.
“But time has come to increase the expenditure in a big way on account of emergence of coronavirus pandemic,” he said.
In the current fiscal’s budget, Tk 29,247 crore has been allocated for health sector, up by 23.44 per cent from the previous fiscal’s revised allocation and it is less than one percent of GDP.
“Allocation to the health sector stands at 5.14 per cent of the total budget for the current fiscal year. With the existing allocation, it is not possible to ensure medical services for all as well as face the health crisis during the pandemic. Spending in healthcare needs to be increased from 5 per cent to 15 per cent in the next fiscal’s budget under a long-term strategic plan,” he added.
Muzaherul Huq, the former WHO expert, also said that the next budget should focus on decentralization of the country’s health system so that village people can easily get access to medicare utilizing the existing infrastructure.
“We have to build upazila health complexes as a center of excellence by providing them autonomy. These health complexes should equip with specialized services and engage necessary manpower and logistics. Management of health manpower should be strengthened to ensure delivery of services. The district civil surgeon should be made accountable in this regard,” he suggested.
Muzaherul Huq also said that the next budget should allocate special fund for local research organizations to explore avenues to fight against the emerging and new emerging diseases like novel coronavirus.
“The government should also strengthen the Public Health Institute. Once it was a center of excellence in South East Asia in research. Unnecessary resources and funds should be provided to it for the development of vaccines for emerging and new emerging diseases,” he noted.
Talking to The New Nation, public health expert MH Chowdhury (Lenin), Chairman of the Medicine Department at the Health and Hope Hospital, said the country’s healthcare system got overwhelmed following the surge in Covid-19 cases. Given the major gaps in medical infrastructure highlighted by the Covid-19 pandemic, we are expecting a major increase in allocation towards strengthening healthcare and research in the upcoming budget.
“The government should come forward with a big investment in the health sector in the next budget and it is necessary to address some of the critical shortages of trained human resources, medical equipment, ICU beds and supplies. We believe that the availability of ICUs could reduce the number of Covid death,” he added.
Dr Lenin Chowdhury also said that the money allocated in the budget may not be enough to meet the needs of health sector. But we have to ensure that the money will be spent properly and without corruption.