The national budget is always at the centre of attention of all economic stakeholders. Allocation of budget among different lines of public expenditure and its efficient implementation significantly impact the economic development and all economic stakeholders throughout the year as well as longer period of time. The main purpose of the budget is to allocate national resources among different sectors for achieving economic development in line with the vision of a nation.
In the context of Covid-19 pandemic, vulnerability of healthcare sector has been exposed in different countries across the world. Especially, some important questions are raised in this context, such as: How much the healthcare sector was prioritized to national policy makers?; Was the budget allocation sufficient for build resilient healthcare system to tackle global pandemic like Covid-19?; Have all nations overestimated the capacity and efficiency of their exiting healthcare systems? etc.
Though resilience of healthcare sector not only depends on the budget allocation but also on efficient implementation of budget and its accountability, here I intend to shed light only on healthcare budget allocation of Bangladesh in last one and half decades for a clear understanding about its strategic priority.
The proportionate budget allocation of different key sectors presented in Figure 1 demonstrates that the percentage of healthcare budget to total budget is decreasing over last fifteen years, which has become the lowest compared to other sectors as well. On the other hand, proportionate budgets for 'Public Administration' and 'Transportation & Communication' sectors have been gradually increasing over the same period, which have become the highest among all sectors along with 'Education and Technology' sector. The graph clearly indicates that public administration, education, and transportation sectors were the top priority of the government to allocate lion's share of resources, while healthcare sector was the least prioritised with a decreasing trend compared to other key sectors for budget allocation.
Figure 2 further shows that though the total national budget in amount has been increased more than eight times in last fifteen years from Tk. 69,740 core in Y2007 to Tk. 568, 000 core in Y2021, healthcare budget has been increased only six times over the period from Tk. 4,742 core to Tk. 28,968 core. This trend implies that healthcare sector does not get the same priority keeping pace with the substantial increasing trend of total national budget of the country.
Annual changes of healthcare budget illustrated in Figure 3 indicates that percentage of annual changes and the changing trend of healthcare budget are not consistent. The healthcare budget of Bangladesh has been increasing in last one and half decade with the highest increasing rate of 30 per ent in Y2018 and lowest 1.2 per ent in 2014. Though the trend of increasing rate was upward from Y2014 to Y2018, the rate sharply deceased afterwards. As the demand of healthcare services in Bangladesh is increasing day by day due to consistent economic growth for last one decade, does this volatile healthcare budget reflect the strategic inconsistency with economic progress of Bangladesh? In addition, the percentage of healthcare budget to GDP presented in Figure 4 demonstrates that healthcare budget was always below one per cent of GDP over the last fifteen years with the highest 0.92 per cent of GDP in 2021 and lowest 0.74 per cent in 2014. Furthermore, according to World Bank data illustrated in figure 5 represents that the percentage of healthcare expenditure to GDP has been consistently lower than other South Asian countries. This illustration also indicates the lesser strategic priority of Bangladesh for healthcare sector compared to other countries in South Asian region as well.
Overall analysis suggests that healthcare sector was not as prioritised as other key sectors in Bangladesh. Specifically, the above illustrations show that healthcare was one of the least preferred sectors among public expenditure lines in terms of budget allocation for last one and half decade. In spite of the consistent economic growth of Bangladesh over the period, healthcare sector has not got the similar strategic priority like other key public expenditure lines such as education, public administration and transportation. However, the current Covid-19 pandemic reemphasises the need for highly efficient and resilient healthcare systems for tackling any unprecedented pandemic in order to protect economic meltdown as well. Although Bangladesh has experienced magical economic performance, particularly in terms of consistent economic growth in the last one decade, the current pandemic forces the policy makers to think differently. Therefore, this is the high time for our policy makers to rethink about different strategic priorities for building sustainable as well as a more resilient economic foundation of the country.
Syed A. Mamun, PhD, FCMA is Deputy CEO, Credit Rating Information and
Services Limited (CRISL).