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Budget and health in coronavirus-hit budget

The federal budget has allocated Rs 650 billion for the Federal Public sector development program for this fiscal year, of which Rs 20 billion goes to the health sector in the wake of COVID-19 pandemic. As compared to the budgetary allocation of the year 2019-20, only 1.132 billion has been added to the health sector and the total figure Rs 14.508 billion. This budget will cover 28 ongoing programs whereas 24 new health schemes are also there in the pipeline.

State Minister Hammad Azhar talked about the ongoing pandemic several times in his budget speech but nothing significant has been given to the health sector for improvement of healthcare services. There is much left for provincial governments in this situation.
In the budget speech, Hammad Azhar expressed hope that provincial governments would play a significant role in the strengthening of the health system. Of them, Rs 676 billion has been given to provincial PSDPs for improvement of health services, to boost the capacity of health institutions, for prevention from communicable diseases, and manufacturing of medical equipment, and only Rs 20 billion has been allocated from the federal government.

In this situation poor public would be treated in the same miserable conditions at public sector hospitals and this planning would not bring any significant change to their lives. Last year, the government proposed an allocation of Rs 13.376 billion to the health sector when there were no special circumstances like COVID-19. For the fiscal year 2018-19, Rs 25.034 billion was announced by the previous government under the public sector development program and Rs 48.701 billion for the fiscal year 2017-18.

The government claimed that they have exempted medical equipment from tax which is being used for the treatment of COVID-19 patients. This step was taken under SRO 237 on March 20, 2020, for three months and now looking at the intensity, the exemption has been extended for another three months on the recommendation of the Ministry of National Health Services, Regulations and Coordination. Budget estimates show that a total of Rs 25.494 billion may be spent on health affairs and services.That is 130.55 percent higher than the budget estimates of the year 2019-20. A sum of Rs 22.774 billion for hospital services, for health administration Rs 2.184 billion, Rs 504 million for public health services, and Rs 31 million for medical products and equipment have been estimated.

Due to the unavailability of medicines and sophisticated diagnostic health equipment, health facilities at primary, secondary, and tertiary levels are minimal and the general public has to suffer badly

Due to the unavailability of medicines and sophisticated diagnostic health equipment, health facilities at primary, secondary, and tertiary levels are minimal and the general public has to suffer badly. Healthcare facilities in the public sector are in poor conditions and this has been exposed in times of recent COVID-19 pandemic. Those individuals who visit public hospitals have to spend more money on diagnostic tests from private laboratories.

Considering the COVID-19 pandemic, value-added tax (VAT) could have been an excellent way of ensuring revenue. Coronavirus has given a key lesson that health sector spending is central to human life where primary health care can never be ignored. Custom duties and regulatory duties should have been permanently removed and Tariff and Para-tariffs including all allied taxes at the import stage for the health and pharmaceutical sector should have been reconsidered to ease these sectors. It would have made the import of personal protective equipment (PPE) easy.

‘Development Budget’ at federal and provincial levels should be given protection by law so that the health budget may not be spent on any other national or local disasters in the future.

Considering health as a provincial subject after the 18th amendment, primary preventive health care should have been taken care of by ensuring funds to basic health units at the community level. Mother and child healthcare, family planning, immunization vaccines should not be forgotten in times of Corona-virus. Children’s immunization from polio would come back in a rebellious way if not given attention because it is ignored since the beginning of the corona pandemic.

There is a need for governance reforms by decentralization of planning and budgeting. District governments may be given a chance to plan their five years of strategies. Regular monitoring, restructuring, and strengthening should be ensured of DG health offices at the federal and provincial levels. Tobacco taxation from the government would have been ensured so that the revenue collection may be given to new startups in the Small Medium Enterprise (SME) Sector.

Training of healthcare professionals in the country must be prioritized and ensured. Mere spending of millions and billions of rupees for constructions of hospitals and purchasing medical equipment would not serve the purpose. There is an immense need to improve emergency medical services. The other ignored segment is the availability of medicines to the public at reasonable rates and the government should give due attention to emergency medical services. Last but not the least;consideration of the transfer of technology must be given attention.

This article was originally published at: Budget and health in coronavirus-hit budget

Approved By SDPI