Growing need to replenish health trust fund

With donors withdrawing, Bhutanese are encouraged to contribute and help sustain free health care in the country 

Donation: A thanksgiving event to past foreign donors of the Bhutan Health Trust Fund (BHTF) will mark the launch of the trust fund’s financing of essential drugs and vaccines on October 14 in Thimphu.

As Bhutan commemorates the 60th birth anniversary of The Fourth Druk Gyalpo, health officials said that the celebration offers an opportunity for past and potential foreign donors to visit Bhutan and witness the benefits, their contributions have made to the health of people. Since its launch in 1998, more than 500 foreign donors have contributed to the trust fund.

The week-long event will also be marked with the nationwide annual health walk on October 11 where some 5,000 people are expected  to join the health community in creating awareness on leading an active lifestyle and reducing non-communicable diseases.

Officials from the health ministry and the BHTF said that the Fund is key to the sustainability of free health care in the country.

While donors have been generous with their contributions, health officials point out that voluntary contribution from the Bhutanese is yet to pick up.

Local contribution comprise only about 0.04 percent of the Fund annually, records with BHTF show.

In 2009-2010 year, the health trust fund’s program officer Dawa Gyeltshen said that about 25 percent of the Nu 1.1 billion was contributed by foreign donors while another 25 percent were contributed by local donors. The government contributed the remaining 50 percent as a matching amount for each donation received.

Since its inception, the BHTF’s objective, he said has been to help sustain primary health care by assuring continued and uninterrupted supply of critical vaccines and essential drugs.

“Vaccines and essential drugs are the main components of primary health care,” Dawa Gyeltshen said. “The entire revenue of one percent health contribution is spent on essential drugs and the BHTF supplements the cost from the interest the fund earns.”

Starting last year, all health contribution is now channelled into BHTF,

Until this year, BHTF has financed vaccines and equipment worth Nu 32 million (M) and starting last year, it has financed the purchase of essential drugs worth Nu 172M.

The fund today stands at Nu 1.3B and BHTF’s target is now revised to USD 30M.

One of the main reasons why health officials are encouraging contributions from the Bhutanese is because donors have started withdrawing their support. “The success of BHTF depends a lot on domestic contribution,” a health official said.

While BHTF was co-financing the cost of pentavalent vaccine until this year with GAVI, it will bear the whole cost of Nu 14M for the vaccine from next year. Health officials also added that the estimated cost of essential drugs for the 2015-16 is Nu 220M.

Health ministry officials said cost factor is the main reason for the country not introducing, for example the rotavirus vaccine, which protects children from rotaviruses, the leading cause of severe diarrhoea among infants and children.

From about 40 percent in the past, foreign aid for the health sector has today declined to about 18 percent, health officials said.

“The cost and obligation to fund routine vaccinations falls on BHTF every time a donor withdraws, which starts as early as 2015,” Dawa Gyeltshen said.

Sonam Pelden

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