Every year, in the weeks before the national budget is read out, the same number is dusted off and put into headlines: the share of total government expenditure being allocated to health. For 2025–26, that share was 6.4 percent. For 2024–25, it was 5.9 percent. For 2018–19, it was 5.7 percent. The line is, on its face, going up. But it is going up at a pace that, ten years on, is no longer plausible to defend.
The Sustainable Development Goals call for a much higher investment than the country is currently making. Even setting aside the SDGs, every cross-country health-financing review of the past decade — World Bank, ADB, BMJ Global Health — has placed Bangladesh in the bottom decile for public health spending as a share of GDP. The result is reflected in something that does not appear in those reviews directly: the share of household spending on health that is out-of-pocket. By the most recent BBS estimate, that share is above 70 percent — among the highest in Asia.
The debate has, for years, been framed as fiscal space. The argument runs: revenue is constrained, the demands on the budget are competing, and a 10 percent floor for health is aspirational. We submit that this framing has expired. The fiscal space exists; what does not exist is the political signal that public health is a first-tier priority. The pandemic could have been that signal. It was not.
This year's budget is unlikely to deliver the 10 percent floor. But the speech the finance minister gives in parliament will, at minimum, tell us whether the country is now willing to name the problem out loud — or whether we will continue to congratulate ourselves on a decimal-place improvement.
BHRF will be tracking the budget speech and the post-budget allocations in detail. Members are encouraged to file their pre-budget commentary through the policy desk.
