Muhammad Mahtabuddin:
The national budget has been proposed at Taka 7.90 trillion, somewhat lower than the previous year’s figure of Taka 7.97 trillion. From media reports, we were disheartened to learn that the proposed health budget in the forthcoming budget would be less than the previous years. Seemingly, the most vulnerable sector of our nation, healthcare, has once again found itself bearing the brunt of fiscal tightening. Bangladesh historically allocates a low percentage of gross domestic product (GDP) to health compared to its neighbouring countries. The allocation for GDP has declined slightly from 0.75 per cent in FY24 to 0.74 per cent in FY25. Such allocation is marginally lower than the average allocation of 0.75 per cent of GDP during FY16 to FY24. The concerned people fear that the ratio would not be better.
If we look back at prior years, we can observe that the allocation for health in the annual national budget was higher. In the fiscal year 2022-23, Taka 29,789 crore was allocated for health, which was 4.5% of the total revised annual national budget. In 2023-24, Taka 38,052 crore was allocated for health which was equal to 5% of the total annual national budget. Lastly, in the fiscal year 2024-25, Taka 41,408 crore was allocated for health, about 5.19% of the total annual national budget.
In February 2025, the Ministry of Health and Family Welfare (MoH&FW) announced a preliminary budget allocation of Taka 434.83 billion for the fiscal year 2025-2026. This is an increase of Taka 20.75 billion above the current allocation of Taka 414.08 billion for the fiscal year 2024-2025. However, it was learned from news that the actual allocation would be far less than the proposed figure. It is a blatant reflection of misplaced priorities and a missed opportunity to strengthen the backbone of our society and public health.
For many years, Bangladesh has struggled with a weak healthcare system plagued by inadequate financial management system, a lack of skilled workers, corruption, and bad infrastructure. We have yet to adequately address Bangladesh’s deficient healthcare system, which has long been beset by subpar facilities, a lack of qualified staff, corruption, and horribly low investment, despite decades of rhetoric and promises. We have certainly failed to overcome the visible barriers obstructing progress in health.
Earlier this year, the Health Sector Reform Commission presented a detailed report to Interim Government, highlighting how corruption, mismanagement, and underinvestment continue to hamper the sector. The report proposes increasing health spending to 5% of GDP and 15% of the national budget to ensure accessible, affordable, and sustainable healthcare for all. The Commission’s solution a significant and urgent increase in investment, not further austerity.
For the first time, an interim government is at the helm of budget planning, yet the urgency to address fundamental issues in public health appears lost in translation. The reduced health budget is a result of extensive corruption in health projects, as acknowledged by the Planning Commission. But it would be like tossing away the baby with the bathwater to penalise a whole people for institutional failure. According to Planning Commission, many projects were axed due to corruption findings. While accountability is desirable, stringent measures in an already weak healthcare system promises disaster. Bangladesh spends 2.36 percent of its GDP on healthcare, which is significantly less than the global average and less than all of its neighbours, with the exception of Afghanistan. The World Health Organisation (WHO) states that at least 5% of GDP should go towards healthcare spending. Regrettably, out-of-pocket expenses in Bangladesh are a dismal 74%, with medications representing 44% of that total. It is too much of burden for the people to bear.
Unsurprisingly, even a simple hospital visit becomes a financial burden for the average citizen. In the past year, costs related to diagnostics, consultations, and medications have surged by 15%. There is also a severe shortage of health personnel. With just 0.7 doctors and 0.49 nurses/midwives per 1,000 people and 24% of positions vacant as of 2021, the country falls 74% short of WHO’s recommended ratios. Cutting funds under these conditions doesn’t just tighten belts; it ties hands. In the meantime, Urban Health was given less importance in the past. Health Specialist expressed their thought that Urban Health needs more allocation and investment. Urban Health specialist Margub Aref Jahangir Unicef stressed more budgetary allocation for Urban Health in the upcoming budget.
The irony is palpable. While policymakers acknowledge the dire state of healthcare and propose structural reforms, the very lifeline, funding, is being ignored. Reform without investment is wishful thinking at best. Critics argue that the logic given by the authority that increased allocations go unutilised fails to address the core problem: inefficient budget utilisation, not overspending. As Dr Zahid Hussain, former World Bank lead economist, aptly put it, “If the spending issues can be resolved, there is no reason why higher allocations should go unused.” The government must reassess how funds are deployed rather than simply trimming allocations. Financial redistribution is crucial, but transparency in critical services such as healthcare is dangerously inadequate. Failing to allocate in the budget and invest in healthcare today will have ripple effects tomorrow. It’s not just about beds and bandages; it’s about economic productivity, human capital, and social equity. The poor suffer most when healthcare becomes a luxury. Already, programmes offering cash incentives to poor mothers and children vital for long-term national development are facing funding cuts.
Bangladesh is at a turning point. It can either continue with short-term budgetary restraint or prioritise health as the foundation of national development. Slashing health budgets while corruption continues unchecked is not fiscal discipline. Rather, it is a policy malpractice. Addressing corruption is necessary, but it is ineffective to penalise the populace by reducing access to necessary services. Reforms are only empty promises in the absence of sufficient funding.
Healthcare is not a luxury. It is the foundation of economic resilience and social equity. Bangladesh must choose vision over scarcity. If the government is serious about achieving universal health coverage, it must invest accordingly. Anything less is a betrayal of commitments to the masses and a gamble with public well-being. Ultimately, a country can only be as powerful as the health of its citizens. And right now, Bangladesh is dangerously anemic.
[Author is a Communication Manager, Eminence Associates for Social Development]
