Everyone had expectations and aspirations to increase the allocation in the national budget of Bangladesh in the fiscal year 2020-21, among all other sectors, especially in the health sector. At the outset of the budget announcement, Finance Minister AHM Mustafa Kamal stated that the impact of Covid-19 has been monitored on the much-needed and unimaginable financial needs and requirements in Bangladesh's health sector.
The budget has been formulated as a step towards normalization to meet this and to compensate for the irreparable loss in various aspects of the economy.
The government is moving ahead with a plan to announce a possible budget of Tk 6 lakh 5 thousand crore as the size of the new budget, which could be a little sideways at the last minute. It is good to say that the size of the original budget in the fiscal year 2020-21 was 5 lakh 68 thousand crore. It cannot be said that this budget was a very special budget in view of the prevalence of diseases in our country and the medical equipment and skilled manpower required for the treatment of emerging diseases.
A special budget of Tk 10,000 crore has been allocated to tackle the coronavirus epidemic in the 2020-21 financial year. Tk 100 crore has been earmarked for integrated health science research. Looking at the last financial year, it can be seen that this allocation was only 5 crore. This time it has been increased 20 times in one step. It is proposed to allocate Tk 850 crore for doctors, nurses and health workers who are working tirelessly day and night to combat the coronavirus.
The cost of protective coronavirus infection protection PPE, gloves, masks, and equipment for intensive care unit management were expected to fall naturally. Health security and safety should have been at the centre of development above all else. On the other hand, along with the health sector, importance should have been given to the social sector related to this sector. Countless people are getting poorer day by day. There was a need to ensure a social safety net for them to curb this trend from poorer to poorer.
The expected importance of the public health system did not seem to be enough. There was a need to introduce health insurance for a large number of poor people. In this, the responsibility of the government in the health sector was considered at a more significant rate. However, considering all the factors, it was not possible for the government to implement it effectively.
In 2017, ESCAPE submitted a special report. Among the 52 countries in Asia and the Pacific in terms of GDP, Bangladesh has the lowest allocation in the health sector. The small amount of healthcare budget allocated for the 170 million people of Bangladesh is not enough to cover the per capita income for all. The people of our country consider all this so they spend 66% of their own pocket to cover the cost of health. As a result, poverty is naturally alleviated and inequality increases. People are deprived of health care and these are the reasons for illness and premature death.
All things considered, the allocation to the health sector should have been ensured. In this budget, the allocation of money should be further strengthened keeping in view the needs of the people for the prevention of diseases, medical treatment, and the allocation for the health sector should be at least doubled in the proposed budget after analyzing these factors.
Increasing the capacity of planned disease control centres has become a matter of urgency. The quality of the medical colleges has been neglected as much as the plans have been made keeping in mind the development of the infrastructure and the unhealthy competition to increase the number of doctors has been neglected.
Although a huge amount of money like Tk 100 crore was allocated for the research sector, the expected success was not achieved. It is a fact that our standards and positions in research are relatively low. One of the reasons behind this can be attributed to the bureaucratic complexity and the tendency among physicians and researchers not to do research.
Prime Minister Sheikh Hasina personally realized the importance and significance of this but even though the allocation was increased a little, no fruitful result was seen. The three main aspects of our health system are health care, health education and research, respectively. Considering the application of basic research and new innovative energy in the field of medicine, Bangladesh has not been able to enter its traditional expected position.
It is just as important to do research on the diseases and infections that are more natural and prevalent. Research on infectious diseases and viral diseases is as important as research on non-communicable diseases such as diabetes, kidney disease, cancer, mental illness, autism, trauma, etc. On the other hand, it is also useful to do research on medical education, epidemiology. There are some basic issues that play a very important role in medicine, such as virology, molecular biology, clinical biochemistry, immunology and genetic labs.
If Bangladesh can invest enough in vaccine production, it is needless to say that just as Bangladesh will be self-sufficient in vaccine production, it will also be possible to earn large sums of money by exporting abroad. Health economics should be the main topic of research. If we have the capacity to develop infrastructure, create skilled health manpower, then unimaginable improvements will be seen in the medical field of Bangladesh. These can be overcome if sufficient transparency is introduced to ensure these.
Ensuring accountability and good governance in the health sector is expected to increase the skilled health manpower as well as bring about unimaginable revolutionary changes in the medical field of Bangladesh. Considerable importance should be given not only to doctors but also to the development of associate nurses. Only then will Bangladesh be able to produce skilled, responsible and dedicated health workers. And we also hope that Bangladesh will be able to do that soon.
The writer is a student of Rajshahi University. E-mail: [email protected]