Health experts have emphasised that simply increasing budget allocations for Bangladesh’s healthcare sector will not suffice; ensuring the effective and timely spending of those funds is equally critical.
During a roundtable discussion titled “Health Budget: Expectations for Higher Allocation and Proper Implementation” held at the National Press Club on Tuesday, speakers noted that healthcare improvements are being stalled by administrative complexities, corruption, manpower shortages, and a lack of coordination.
Professor Syed Abdul Hamid of the Institute of Health Economics at Dhaka University stated that government spending on health has not yet reached 1% of the GDP.
As a result, the public is forced to bear the majority of healthcare costs personally. “For every Tk100 spent on health in the country, people must pay approximately Tk80 from their own pockets,” he said, adding that this must be reduced to 30% to achieve Universal Health Coverage.
The discussion revealed that in the last fiscal year, the health sector received an allocation of 41,908 crore Taka out of a total budget of approximately 7.9 lakh crore Taka, accounting for 5.3%. However, a large portion of this allocation remained unspent by the end of the year.
According to Professor Hamid, delays in the release of funds, complexities in the Public Procurement Act, centralised control, corruption in audit and accounts offices, and the limited decision-making power of hospital managers prevent the timely expenditure of health funds.
He further remarked that a culture has emerged where “it feels safer to not work.”
He argued that the current procurement system is designed for infrastructure construction rather than the practical demands of healthcare, leading to shortages of essential equipment, medicine, and maintenance services.
Even when equipment is available, some hospitals lack operators, or surgeons are left without anaesthesia specialists. Furthermore, weak supply chains result in significant amounts of medicine being wasted or reaching their expiry dates.
Abu Muhammad Zakir Hussain, a former member of the Health Sector Reform Commission formed under the interim government, pointed out that many hospitals possess modern equipment but lack the trained personnel to operate them.
He recommended that at least 15% of the budget be specifically allocated for equipment maintenance.
Health economist Mohammad Shadrul Alam argued that health spending should be viewed as a national investment rather than a mere expense. He stressed the necessity of introducing a health insurance system, noting that healthcare costs are driving many people into poverty every year.
Vaccine expert Tajul Islam A. Bari noted that only 30% of the health allocation was utilised in the 2025–26 fiscal year. “The lack of money is not the primary problem; political will is required for effective implementation,” he said.
Dr Zahirul Islam Shakil, Secretary General of the Doctors Association of Bangladesh (DAB), stated that 35% to 40% of the development budget is returned annually because it cannot be spent within the designated time.
He explained that funds often do not reach projects until December or January after the budget is passed, leading to further delays in tenders and construction, often pushing project starts back by two to three years.
Dr Shakil also raised concerns regarding the safety of health workers, reporting at least 28 incidents of violence in medical institutions and against doctors over the past month.
Member of Parliament Moslehuddin Farid highlighted a severe shortage of nursing staff, noting there are only five nurses for every 10,000 people. He suggested that the financial pressure on the public could be significantly eased if unnecessary medicines and medical tests were reduced.
The roundtable was organised by the private research firm Public Integrity Network for Evidence and Transparency (PINET).
