Health expenditure still less than five percent of GDP

Spending on health is declining over the years, and especially so in the last five years. Records show that health spending, in terms of GDP, remained at less than 5 percent while the global experts recommends spending at least 5 percent of GDP in country, like Bhutan.

Talking to an official from MoH, it is learnt that, in terms of proportion, it is declining but in terms of absolute number it is still increasing. “The allocation of Nu 3.5 bn is not the sole allocation to the plan,” he added.

He said, “What we have on top of the Nu 3.5 bn is, we have secured Nu 10 bn for the Multi Disciplinary Super Specialty Hospital (MDSSH) which the GoI (Government of India) has already committed to, health flagship program might bring in another Nu 1.5 bn, and likewise more programs.”

Thereby, he said that apart from Nu 3.5 bn, if every program comes through, there is around Nu 15 bn for the plan. However, 12th FYP targets to 5 percent of the GDP.

Health Minister Lyonpo Dechen Wangmo said that people look at how the 12th FYPs are formulated, however, it was actually formulated by the previous government.

So the fundamental problem is that, looking at the past two governments, the plan activities where similar and nothing major till now, Lyonpo added. The manifestos of the four political parties were 90 percent same, the only different with the current government was the health agenda.

Lyonpo said, “People elected us based on the health agenda, and in health agenda, we have tertiary hospital which will easily cost around 9 bn to 10 bn.  Breast feeding program which will cost around 1.19 bn, medical camp program which will cost around 2 bn and flu vaccination which will cost around 600 mn.”

In total, there is 12 bn to 13 bn, which is not enough, she said, adding that plan is 3.5 bn for five years. “We will take our pledge, 12 bn, three times the annual five years health budget.

And we are shouldering this responsibility. Our performance will not only be based on the five year indicators but our performance will be based on our pledge to our people,” she added.

She added that the process of 12 FYP plan isn’t still relevant in 21st Century because everything is evolving so fast. “We cannot forecast what will happen in the next five year plan because things will change,” she said, further adding, “We always focus on coverage and our policy must be progressive and based on the needs of the people.”

Health ministry has a budget deficit of about Nu 12 bn. Lyonpo, in line with this, said that she is excited rather than being worried because it is a challenge for her, the ministry and for the whole team, to prove that they need to mobilize three times their annual budget and their five years budget.

Chief Planning Officer, MoH, Tashi Penjor, shared that they have five programs to enhance public health in 12th FYP; governance, health workforce and financing (Nu 88.0 mn); health promotion and disease prevention (Nu 523.0 mn); medical services (Nu268.0 mn); medicines, healthcare technologies and infrastructure (Nu 2511.0 mn) and traditional medicine services (Nu 190 mn).

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