Boost health sector by reallocating budget share of energy

The role of power and energy for economic development is paramount. Unfortunately, when the Awami League government came into power in 2009, they inherited a weak, dishevelled, fragile energy sector.

To overcome the crisis, the government introduced major reform initiatives to minimize the country's long-lasting nagging electricity crisis.

Only 47 percent of the population had access to electricity then, but now, nearly 95 percent of the population is under electricity coverage.

Installed capacity has increased from 5,272 MW in 2009 to 20,514 MW in 2020 (as of June 2020). Furthermore, per-capita electricity consumption had increased from 220 KWh in 2009 to 375 KWh in 2019.

On the other hand, health had been neglected whenever it came to its meaningful and requisite slice in the budget share.

As a result, people had to rely on expensive private healthcare facilities, resulting in significant increase in out-of-pocket payments. Consequently, many people went to the point of impoverishment due to hefty health expenditures.

Covid-19 has exposed the weakness of our health system, which had been in a complete disarray since long before. The infection is still on the rise in Bangladesh, posing a serious risk to the health and economy of the country.

While fighting Covid-19, people expected a significant increase and meaningful reallocation in the budget for the health sector.

Though there has been a strong demand for such for long, Covid-19 has strengthened the voice. Unfortunately, the budget did not completely follow suit.

In addition to that, budget allocations should be made with specific activities in mind. A "thok boraddo" or lumpsum allocation of Tk10,000 crore might all end up in misuse or inappropriate spending, such as in buying health equipment, that may not be essential after a while.

The share of health budget is only 5.26 percent of the total budget in Bangladesh and it is only 0.92 percent of the GDP of FY 2020-2021, which is the lowest among the South Asian countries. Photo: UNB

The government should emphasize more on allocating money to establish field-based health centres that can be rapidly set up to provide services to the patients suffering from Covid-19, and easily dismantled and reused later for other seasonal disease burdens such as dengue, malaria or diarrheal outbreaks in different parts of the country.

Although, it is now evident that most of the recent epidemics, such as SARS, MARS, Ebola, and the pandemic of the century – Covid-19 can best be dealt with social and behavioural health awareness programs designed by public health professionals, still one-third of our annual budgetary allocations are going to be spent for paying wages, building infrastructures and buying machineries in FY 2020-21.

Expenses in these categories in the last few decades did not bring much benefit to the people who are now fighting over just a bed in the hospital, let alone enjoy facilities such as Incentive Care Unit (ICU), high flow oxygens or ventilators.

The allocated amount for the health sector is Tk29,247 crore, which is a 2 percent increase from the revised allocation of Tk23,692 crore for the fiscal year 2019-2020.

However, the share of health budget is only 5.26 percent of the total budget and it is only 0.92 percent of the GDP of FY 2020-2021, lowest among the South Asian countries.

If a significant portion of this is received from the World Bank and ADB, then this increase would not reflect government's claim of considering the health sector a top priority.

The key challenge of increasing budget for the health sector is the fiscal space. The allocation can be made more efficient if the government reallocates money from one sector to another.  

Keeping pace with the growth, electricity generation as per demand has increased substantially in the last few decades.

Sakib B Amin PHD, is an associate professor of North South University and expert on energy economic

Shafiun N Shimul PHD, is an  associate professor of University of Dhaka and a health economist 

Shamim Ahmed, is adoctoral researcher at University of Toronto and a public health expert