Health Sector Allocations Receive 37% Boost in Pakistani FY2008/09 Budget

Pakistani Healthcare Budget

Family planning, immunisation, and healthcare development in Pakistan's cities are the focus areas of the Pakistani healthcare budget allocation for FY2008/09. The government has allocated 19 billion rupees for healthcare in its budget, constituting a 37% y/y increase in government healthcare allocations. Of the budget allocations, 11.5 billion rupees (60% of the budget) will go towards family planning and immunisation programmes; meanwhile, 7.5 billion rupees (40% of the budget) will go towards development projects, mother and child health projects, and infectious disease control programmes for malaria, HIV/AIDS, and hepatitis.

A total of 111 development programmes have been earmarked for the year; only three are new projects (constituting 600 million rupees), with the rest continuing from last year. Some 1.7 billion rupees has been allocated for upgrading and expanding 31 existing facilities in such cities as Islamabad, Lahore, Faisalabad, Karachi, Hyderabad, Peshawar, and Quetta. Twenty-eight new health-related institutions are also set to be opened across the country, although 17 projects from the 111 project development list have not been allocated any funding at all in the budget.

Besides development projects, 2.5 billion rupees has been allocated for mother and child health, with national malaria (100 million rupees), HIV/AIDS (182 million rupees), and hepatitis (487 million rupess) control programmes also gaining focus. The budget has also accounted for a doubling in the number of "lady healthcare workers" (LHWs) to strengthen its national programmes across the entire spectrum, from the current 100,000.

Outlook and Implications

Pakistan has consistently increased its healthcare budgetary allocations, with this year being no exception to the rule. However, government's healthcare allocation constitutes only 0.8% of the 2.25-trillion-rupee total budget for the fiscal year—grossly low even compared with other developing economies such as India. Although the government has pledged to increase healthcare expenditure by 0.2% of GDP each year, it is likely to remain at the existing 0.8% of GDP even this year. Healthcare delivery and insurance will continue to be dominated by private players in the short to medium term, with over 60% of healthcare expenditure being out of pocket. Public sector expenditure is low, with annual expenditure at US$4 per capita, compared with WHO recommendations of US$34 per capita.

There has been little mention of rural healthcare development on the whole in this year's healthcare budget, as indicated by the allocations. Healthcare infrastructure will suffer significantly, with accessibility affected in rural areas. Notably, development programmes for rural districts—especially south Punjab, interior Sindh, and Balochistan—are missing. Further, hepatitis allocations are starkly insufficient in a country where 5% of the population is reportedly afflicted with the condition, according to Pharmabiz.com. The allocations for Sindh province alone surpassed those for hepatitis by 4.5 billion rupees. However, much of the Sindh government's allocations may well be coming from international donors.

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