The Bhutanese Leading the way.
During the Meet-the-Press held yesterday, the Health Minister, Tandin Wangchuk, addressed critical concerns regarding kidney transplant patients, focusing on the challenges of ABO-incompatible kidney transplants, the revision of the Daily Subsistence Allowance (DSA) for patients undergoing treatment in India, and the status of the revised referral policy.
The Health Minister highlighted the government’s commitment to improving healthcare accessibility for citizens in need of life-saving treatments.
According to data from the Bhutan Kidney Foundation, more than 411 Bhutanese citizens are currently undergoing dialysis, with many struggling to find compatible kidney donors.
In light of these challenges, ABO-incompatible kidney transplants, which have been successfully conducted in India, present a viable alternative. These procedures allow patients to receive a transplant from a donor with a different blood type, a method made possible by advancements in medical technology.
However, Bhutan’s current referral policy does not allow for these types of transplants, leading to prolonged suffering for patients and their families.
Lyonpo confirmed that while ABO-incompatible transplants are already being performed in countries like India, the current referral policy does not accommodate them. However, Lyonpo assured that a revised referral guideline is in the works, which includes provisions for ABO-incompatible kidney transplants.
“The draft revised referral guideline includes provisions for ABO-incompatible kidney transplants. This revision was made to address the challenges faced by patients who are unable to find compatible donors,” Lyonpo said.
The revision aims to ease the referral process for patients and open up new avenues for kidney transplantation. Once the revised guideline is finalized, it will be presented to the High-Level Committee of the Health Sector (HLC) for recommendation and then to the government for approval.
While the inclusion of ABO-incompatible kidney transplants is a promising development, it comes with an estimated additional cost of Nu 200,000 to 250,000 per patient, which includes treatments such as plasmapheresis (a medical procedure that removes harmful substances, such as antibodies, from the blood), and intravenous immunoglobulin injections (a treatment where antibodies are injected into the veins to help protect the body from infections and support immune function).
This financial burden is seen as a necessary investment to alleviate the suffering of patients.
Addressing another pressing concern, Lyonpo acknowledged the financial difficulties faced by patients undergoing treatment abroad, particularly in India, where they struggle with the existing DSA of Nu 150 per person for the first month and Nu 125 thereafter.
Lyonpo further emphasized that the government is committed to the welfare of its citizens and ensuring equitable access to healthcare. “This increase is a necessary adjustment, as the current DSA rates of Nu 150/- for the first month and Nu 125/- from the second month were established over two decades ago and no longer reflect the current cost of living,” he said.
The government’s current DSA rates, established over two decades ago, no longer reflect the rising cost of living. To address this, the revised referral guideline proposes an increase in the DSA to Nu 400 per person per day.
“The proposed DSA rate is Nu 400 per person per day, which is aligned with the minimum national wage rate and accounts for inflation and the recommendations from the Bhutan Kidney Foundation’s case studies,” Lyonpo said.
The revised DSA is expected to alleviate the struggles many patients and their families face while receiving treatment abroad, allowing them to focus on the patient’s recovery rather than the financial burden of daily living costs.
This process is expected to bring the revised policy into effect and improve the accessibility of advanced medical procedures for kidney patients. “Once the guideline is finalized, it will be presented to the High-Level Committee of the Health Sector (HLC) for recommendation and subsequently to the government for approval,” Lyonpo said.
