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Bhutan Health Trust Fund
The Royal Government of Bhutan (RGoB)
has sought to use its limited resources to develop equitable and sustainable
social systems, with particular focus on health and education. With the aim
of meeting the basic needs of the people, the social sector was accorded
highest priority in each of the country's development plans. This is clearly
reflects in the current plan which allocates 22% of the national budget to
the social sector including 8.5% to the health sector. To ensure maximum
geographic access, the RGoB has focused on
developing primary health care infrastructure. This reaches almost every
village in the country through a network of 28 hospitals (one in every
district), and 149 Basic Health Units (BHUs) with
426 Outreach Clinics. Basic health services coverage is over 90% of the
population.
Guided by a firm political will, and confident in the
strong foundation of a well-knit health infrastructure, the RGoB is exploring innovative and sustainable financing
mechanisms for the priority components of its primary health care services.
To continue its preventive programmes and to
provide basic curative services, the availability of vaccines & essential
drugs, including needles and syringes is crucial. At present, the cost of
vaccines and drugs accounts for almost 50% of all expenditures in the
national health sector, leaving uncertainties in the future. Therefore, the
establishment of a "Health Trust Fund" of US $ 24 million would eliminate
the uncertainties and generate sufficient income to meet the cost of these
critical components of the health services in Bhutan.
The primary objective of the Fund is to ensure sustainable
and timely availability of resources for the highest priority health care
service components. By ensuring the financing of these crucial components
through a Trust Fund, the RGoB can re-direct the
national health budget to other key areas, such as developing human resources
and strengthening monitoring and surveillance systems. The RGoB's resolve to fulfill this objectives is clear from
its willingness to subscribe up to half the amount needed for the Fund
despite its limited resources. Indeed, the RGoB
will match every donor contribution US dollar for dollar. Within 15-20 years,
the economic capacity of Bhutan
is expected to improve substantially. Investments in the private sectors and
in certain lucrative projects, such as the promising hydro-electric industry,
are expected to raise the income of the Bhutanese people and generate a
healthy revenue for the national exchequer. At that time, the RGoB and its Fund partners will review the impact of the
Fund and determine the most judicious course of action for its future role.
The quantity of vaccines, essential drugs and needles
& syringes is determined accurately. In 1997, procurement costs amounted
to US $ 1 million and it has increased to US $ 1.6 million by 2002. The Fund
will be managed prudently while ensuring an annual return needed to meet the
cost of the said medical components. It is expected that the Fund will
generate about 5% interest over US inflation. Any excess income
is proposed to be reinvested in order to increase the fund capital to meet
the rising costs.
The Health Trust Fund is vitally important for Bhutan to
ensure the timely availability of critical vaccines, essential drugs and
needles & syringes. These components together form the backbone of
Primary Health Care services for the physical and mental well being of the
people of Bhutan.
By contributing to this Trust Fund, the RGoB and
the contributing partners will help achieve an equitable and sustainable
primary health care system for the entire population of Bhutan.
Beyond this, the partners will have established an innovative and viable model
for promoting and sustaining the costly delivery of primary health care
services in the developing world.
An appeal is made to all donors to contribute generously
to the proposed Health Trust Fund to achieve a target of US $ 24 million.
With the 'one-to-one' matching contribution to be made by the Royal
Government of Bhutan, the donor contribution requested is US $ 12 million.
Arcticles on Move for Health
walk across the country by the Health & Education Minister Lyonpo Sangay Ngedup and his
six-member team.
by Norbu Wangchuk
NPO (AO)
WHO Country Office
in Bhutan
1. From Move for Health to Health Marathon
2. Health Marathon in Bhutan : A Success!
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