Welcome move to reduce citizens' healthcare costs

FE Team | Published: June 05, 2026 20:39:13

The incumbent BNP government's health sector allocation in the proposed budget for the next financial year (FY2026-27) marks a clear departure from those of the previous governments. Historically, the health sector allocations were not only routinely kept below 1.0 per cent of the GDP, but also a large part of whatever amounts were earmarked remained unspent.
Notably, in the proposed FY (2026-27)'s development budget, the health sector might get an allocation of Tk 355.30 billion, which is 11.86 per cent of the total ADP outlay, making it the third largest sector-wise allocation after transport and education. Obviously, this is a major boost for the health sector aimed at accelerating the rollout of health cards and the ruling party's election manifesto commitments. In this connection, the Finance Minister Amir Khosru Mahmud Chowdhury at a recent discussion event held in the city told the audience that the government would introduce Universal Healthcare (UHC) in the next budget. Of course, the government's decision is welcome as it is indisputably a step in the right direction. Unfortunately, the country's citizens bear a staggeringly high out-of-pocket (OOP) expenses which hovers around 75 per cent of their total healthcare costs. Small wonder that this enormous burden of meeting their healthcare expenditures has been pushing around 3.7 per cent of the total population which is over 6.0 million people below the poverty line every year. Under the circumstances, granted that the governments' move to make healthcare accessible to all with an emphasis on protecting the low-income and marginalised people is well-intentioned, yet, the implementability of the proposed health budget in the next ADP will remain an open question.
Such observation is based on earlier experience centring around the implementing agencies' poor performance regarding the projects under the health ministry. Consider that in the first 10 months of the current financial year (FY26), only less than 10 per cent of the annual allocation could be spent by the project implementation agencies under the health ministry. On this score, experts are of the view that such performance deficit has to do with weak implementation capacity, a cumbersome procurement and approval regime and the time-worn budgeting culture. In that case, effective utilisation of the health sector allocation is predicated on the government's commitment on carrying out institutional reforms and introducing the practice of sound financial management.
It is worthwhile to note at this point that during the interim government a Health Sector Reform Commission was constituted which was in favour of raising the health sector spending to 5.0 per cent of the GDP. Gratifyingly, the health expenditure target as spelt out in the ruling party's election manifesto also reflects an identical position. So far as the nation-wide implementation of the UHC projects as proposed towards reducing the public's OOP expenses is concerned, the good news is that the incumbent government has also expressed its intention to involve the private sector as well as the NGOs.
Given the private health service providers' and the health sector NGOS' long experience in executing programmes similar to those to be undertaken by the government for the health sector in the next ADP, it is expected that the move might help overcome the implementation-deficit that was symptomatic of the past cases of the government's healthcare projects. However, there are also other discrepancies in the existing healthcare delivery system of the government that need to be addressed. Those include a lack of skilled healthcare personnel, unequal distribution of resources between the urban and rural areas and heavy dependence of private healthcare providers, and so on. But going by the history, a mere goodwill, or just the size of the allocation for the health sector is not enough to improve the country's poor healthcare service. What matters is the political will of the government. Hopefully, the present government has that will and can live up to its pledges.