TUHIN SHUBHRA ADHIKARY

The government’s decision to nearly double the health development budget for the next fiscal year has been welcomed as a step in the right direction though serious doubts persist over the implementation capacity of health authorities.

Under the new Annual Development Programme (ADP), the health sector has been allocated Tk 35,530 crore for fiscal 2026-27 -- up from Tk 18,148 crore in fiscal 2025-26 -- representing 11.86 percent of the total ADP outlay. It is the third-largest sectoral allocation, behind transport and communication and education.

The budget increase, however, comes against a backdrop of poor expenditure performance by the two divisions under the health ministry, the primary users of health funds. In the first 10 months of the current fiscal year, the two divisions spent approximately Tk 933 crore -- less than one-tenth of their annual allocation.

Experts attribute the shortfall to weak implementation capacity, cumbersome procurement and approval processes, and outdated budgeting practices. While a larger health budget is necessary, they argue that institutional reform and sound financial management are equally -- if not more -- critical to ensuring funds are used effectively.

Health campaigners and experts have long pressed for greater investment in the sector, which has languished below one percent of GDP for over a decade. The Health Sector Reform Commission, constituted during the interim government’s tenure, called for raising health spending to 5 percent of GDP -- a target mirrored in the BNP’s election manifesto.

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