Covid-19 treatment health care facilities should be equipped with pulse oximeters, and functioning oxygen systems including single-use oxygen delivery interfaces
Although a large lump sum amount of money has been allocated in the FY 2020-21 budget to fight against the deadly coronavirus, the government is yet to disclose any guideline for utilizing this fund.
Usually, the government spends a lump sum allocation for solving an emergency crisis. But Covid-19 is not only an emergency, but also a heath disaster, a global pandemic, which has already claimed many precious lives. How many days the pandemic will be continue nobody yet knows.
So, a guideline is necessary for using the lump sum amount owed in the budget this year. All the affected countries, including Bangladesh, have been emphasizing over three issues. One is to control the spread of coronavirus, secondly, ensuring test and treatment of infected patients, and finally, to discover a suitable Covid-19 vaccine.
Bangladesh can be given a priority on second and third issues to spend the lump sum funds, as we all are having a difficult time due to inadequate tests and treatment.
Health budget and stimulus packages
On the eve of the Covid-19 pandemic, there was much expectation that the health sector would be overhauled through strategic views and innovations set out in the national budget of FY2020-21.
And the steps government has taken will inadequately meet the aspirations and requirements of the people. Moreover, according to WHO, out-of-pocket expenditures for health care of households in this country comprises a 74% share of the total health expenditure and collectively spent approximately 2.27% of GDP, which indicates a huge financial burden on people, especially on low and middle-income groups.
In order to combat the Covid-19 pandemic, the government has allocated Tk29,247 crore for the health services and health education in the FY2020-21, with an increase of 23.44% compared to the revised budget of FY2019-20, adding up to Tk 23,692 crore.
A total of Tk22,884 crore will be spent in health services whereas Tk6,363 crore has been allocated on health education and family welfare in the current fiscal year. To tackle Covid-19, the government has allocated an emergency allocation of Tk 529crore for the health sectors.
The government has allocated an amount of Tk10,000crore as a special lump sum to deal with the Covid-19 pandemic. The government has also allocated Tk850 crore to the doctors, nurses, and health care workers who are providing health services, as a special honorarium and compensation for infection or death.
In addition, the government has allocated Tk100 crore to form “Integrated Health- Science Research and Development Fund” for the development of research in health-education, science and technology.
In total, Tk41,027 crore has been allocated for the health sector in the current fiscal year which is 1.29% of GDP and 7.2% of the total budget. A total of 13 ministries and departments are involved in implementing different programs related to health and family welfare.
How to spend the lump sum fund?
Covid-19 has spread all over the country. This has been creating hurdles to the villagers to avail the basic health care services from the upazila health complexes. So it is time to think over scaling-up modern health facilities in Community Clinics (CCs) so that villagers can get their basic health care service at their doorsteps.
As of now, 13,812 CCs have been in operation throughout the country, and the government is going to set up 1,029 new CCs in this fiscal year.
CC is the lowest tier health care delivery network for ensuring quality Primary Health Care (PHC). It is the basic health care service outlet for maternal and neonatal health care services, integrated management of childhood illness, reproductive health and FP services, EPI, nutritional education, micro-nutrient supplements, and health education and counseling.
Besides these, the government might consider to modernize the hospitals of the poor (CCs now treated) by including new services like adolescent health care or school health services.
Experience from China suggests that the majority of people with Covid-19 have mild illnesses (40%) or moderate illnesses (40%); about 15% of them have severe illnesses requiring oxygen therapy, and 5% will be critically ill requiring intensive care unit treatment.
In addition, most critically ill Covid-19 patients will require mechanical ventilation. Covid-19 treatment health care facilities should be equipped with pulse oximeters, and functioning oxygen systems including single-use oxygen delivery interfaces.
It is reported that critical Covid-19 patients have been admitted in district and divisional hospitals in Bangladesh. Therefore, it is required to set up a sophisticated ICU unit and most importantly reliable Covid-19 testing facilities in every district and divisional hospital equipped with oxygen cylinder and ventilation facilities, taking funds from the allocated lump sum.
Recently Globe Biotech Limited, a Bangladeshi company, has claimed to be the first company to have a Covid-19 vaccine under development. This is really a praiseworthy endeavour.
Coronavirus has created a huge global health crisis that has had a deep impact on the way we perceive our world and our everyday lives in thousand different ways. The government has taken several steps to tackle the Covid-19 pandemic in the country, but that is not enough, because the treatment facility here is comparatively poor, bogged down by mismanagement and corruption.
It would be wise to utilize the bulk of the budget to improve the treatment facilities, innovating vaccines, and buying medical equipment to provide better treatment and building capacity of the health professionals in this ongoing fight against Covid-19.
Md Shohel Mamun, Hussain Ahmed, Md Mizanur Rahman, and Ahmed Ekramullah are students of Development Studies at the University of Dhaka.