In the proposed FY2026-27 national budget, the Government of Bangladesh has allocated Tk 69,409 crore to the health sector, out of a total budget of Tk 9.38 lakh crore. While this is almost twice as much as was budgeted for health in the previous fiscal year, the real measure of success will be whether resources translate into better health outcomes and financial protection for citizens.
Despite significant improvements in major health indicators over the past few decades, such as life expectancy, infant and child mortality, total fertility rate, and so on, thanks to strong field-level public health programmes, Bangladeshis continue to bear one of the highest levels of out-of-pocket health expenditure in South Asia, with households financing more than 79 percent of total health spending. As a result, illness remains a major cause of impoverishment. Strategic investment in health can improve population health and life expectancy, reduce poverty caused by healthcare costs, increase workforce productivity, strengthen the national economy, and promote social equity and cohesion.
A notable feature of the FY2026-27 health budget is its emphasis on transforming the healthcare system from a treatment-oriented model to a prevention-focused one. The budget prioritises strengthening primary healthcare services in both rural and urban areas, promoting disease prevention and health awareness, improving maternal and child health, enhancing nutrition programmes, expanding immunisation coverage, and ensuring early detection of non-communicable diseases such as cancer and diabetes.
The government has also proposed several measures to improve access to essential healthcare services. Tax and VAT exemptions on selected medical products, including stents, intraocular lenses, cancer medicines, dialysis-related equipment, and raw materials, are expected to reduce treatment costs. Plans have also been announced to establish dialysis units and coronary care facilities in district hospitals, expanding access to specialised services beyond Dhaka.
The budget further emphasises investments in the health workforce and health systems. The government has announced plans to recruit 5,000 MBBS doctors to fill longstanding vacancies and 1,00,000 additional health workers, the majority of whom are expected to be women. Other initiatives include establishing a National Ambulance Pool and Emergency Service Network, introducing an e-Health Card for citizens under the framework of Universal Health Coverage, upgrading district hospitals into fully functional secondary healthcare facilities, and expanding primary healthcare units across unions and urban wards.
The budget also recognises the health implications of environmental policies. Air pollution remains the leading environmental risk factor for disease in Bangladesh. Measures aimed at encouraging cleaner transportation, including higher taxes on conventional vehicles, reduced taxes on electric vehicles, and duty exemptions on EV charging infrastructure, could contribute to lower levels of air pollution. Cleaner transport systems can also reduce exposure to particulate matter and nitrogen dioxide, thereby lowering the burden of respiratory and cardiovascular diseases.
Although the health sector has received a substantially higher allocation in the budget, Bangladesh has historically struggled to use development budgets efficiently, and weak institutional coordination has often undermined intended results. A number of systemic issues have been identified to explain this, including a lack of transparency and accountability in recruitment, procurement, and infrastructure development, with corruption persisting across these functions. Other key weaknesses include inadequate managerial capacity on both central and local levels, weaknesses in public financial management (especially in budget planning, spending, and auditing), inefficient procurement systems, and long delays in project approval.
While the abovementioned technicalities put into doubt the efficient execution of the health budget, there are equally important programmatic issues which prevent impactful outcomes from the money spent. The quality of government programmes (particularly facility-based services) suffers from inadequate supplies; lack of adequate, trained manpower due to vacancies and absenteeism; inadequate/non-functional equipment; patient overload, especially in secondary and tertiary facilities; lack of attention to instituting quality of care processes in the service delivery structure; lack of service coverage in rural and remote areas; and lack of comprehensive public health infrastructure in burgeoning urban areas.
Despite a thriving private health sector, which is the first point of contact for many healthcare seekers, private facilities also remain unregulated and expensive, working in parallel with the public sector and thus depriving the health sector of benefiting from its large infrastructure.
Against this backdrop, promoting disease prevention; raising public awareness regarding health, family planning services, and commodities supplies; enhancing maternal and child health services; improving nutrition; expanding immunisation coverage; and ensuring early detection of non-communicable diseases such as cancer and hypertension are areas of priority. If these priorities can be addressed through sustainable programming, system improvements, and establishment of accountability and transparency, Bangladesh could be on a trajectory of significant improvement in its health sector. Not only will the health of the population improve along with the general quality of life and productivity, but out-of-pocket expenditure will also be reduced, paving the way towards achieving the SDG target of Universal Health Coverage by 2030. Optimising the use of all available resources (both in the public and private sectors); timely allocation and release of funds; systemic improvements and adjustments; and strong, focused leadership will be the building blocks for making this transformation. Effectively integrating the proposed e-Health Card into broader social protection systems will also decrease costs and increase efficiency.
The success of the FY2026-27 health budget will therefore depend not on the size of the allocation alone but on the quality of its implementation. To translate ambition into results, the government must establish a clear implementation roadmap, strengthen oversight mechanisms, enhance transparency and accountability, and rapidly prioritise projects for approval and execution. Only then can the vision of “Health for All” move beyond aspiration and become a reality for every citizen of Bangladesh.
Shaikh Masudul Alam is program director at Bangladesh Health Watch.
Views expressed in this article are the author's own.
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