An ‘earnest appeal’ from health ministry and some serious allegations

There have been many allegations of mismanagement, irregularities and corruption against the health ministry. There also have been complaints about its inability to spend allocated money. Recently, the ministry responded to some of the allegations by publishing an advertisement with the title of "earnest appeal", wherein it claimed to have spent Tk 8,000 crore for providing medical services. Some serious questions, however, have been raised about some of the issues or information mentioned in the ministry's ad.

First, let us talk about the RT-PCR machines.

The health ministry mentioned that it had set up 97 RT-PCR laboratories costing Tk 300 crore. In other words, it means that they had bought 97 RT-PCR machines, and the price of each machine is more than Tk 50 lakh. The ministry failed to mention the machines' brand name or the country from which it bought these machines. The American-made Bio-Rad is known for providing the best-quality RT-PCR machine in the market, and it has also been approved by the FDA. Bangladesh's Gonoshasthaya Kendra (GK) and some other private organisations have procured these devices. During the coronavirus pandemic, the total cost for opening an LC, bringing in a device from the USA and setting it up on the GK premises was estimated at about Tk 22 lakh. This is the cost of procuring and installing a RT-PCR machine. You can save up at least Tk 2 lakh if 10-20 machines are bought in bulk.

So the question is, which brand of RT-PCR machines did the health ministry procure, and from which country, that ended up costing more than Tk 50 lakh per machine?

It has been also claimed in the advertisement that each RT-PCR test costs Tk 3,000. The ministry has conducted over 65,06,781 tests so far, and the total cost for the tests stands at Tk 1,952 crore.

The government uses South Korea's Sansure kit for conducting the RT-PCR tests. Sources at two private hospitals tell us that conducting an RT-PCR test using the Sansure kit can cost a maximum of Tk 1,700. And if 90 samples are tested at once in a batch, the cost comes down to Tk 1,200. Thus, there are enough reasons to doubt the accuracy of the health ministry's information about the expenditure of Tk 3,000 per tests and Tk 1,952 crore in total.

The total number of tests done raises a bigger question. The health ministry's advertisement was published on July 9. It was prepared the day before, on July 8. Thus, it is logical to assume that the advertisement included information dating to the 8th of July. However, till July 8, according to official government estimates, a total of 50,21,221 samples have been tested using government facilities. This figure is 14,85,650 less than the number mentioned in the ministry's advertisement! Reducing these extra tests reduces the cost by Tk 450 crore. What's the explanation for this anomaly in the ministry's calculation?

Now let's come to the issue of vaccines.

The health ministry has mentioned in its advertisement that so far it has procured one crore and one lakh and 50 thousand doses. Each dose cost about Tk 3,000. So far, Bangladesh has procured 70 lakh doses of the Covishield vaccine, developed by Oxford-AstraZeneca and manufactured by the Serum Institute of India. We also received 33 lakh doses from India as gift. The government then procured 25 lakh doses of Moderna and one lakh and six thousand doses of Pfizer. It also bought 20 lakh doses of Sinopharm vaccine from China, and got 11 lakh doses as gift.

In short, the government reportedly received a total of 44 lakh doses as gift, and procured a total of one crore and 16 lakh and six thousand doses. This is all publicly available information.

In the ministry's advertisement, however, it claimed to have procured one crore and one lakh and 50 thousand doses. Thus there is a discrepancy of 15 lakh and 46 thousand fewer doses between published news and the advertisement from the ministry. What might be the reason behind this discrepancy? Does it mean that the ministry doesn't have a clear picture of its vaccine inventory? Apparently, the ministry also does not have accurate records of how many doctors have passed away and how many have retired, which came to light after the incident of promoting or transferring deceased and retired doctors. The same thing apparently happened with the vaccine inventory, too.

Now, let us address the main issue.

It was mentioned in the advertisement that Tk three thousand and 45 crore was spent to procure one crore and one lakh and 50 thousand doses of vaccine. Each Covishield dose cost USD 5. This cost includes charges involved with shipping the vaccine from India and delivering it to the government's depots. If we take Tk 85 as the exchange value of one dollar, the cost of each dose comes to Tk 425.

The government procured China's Sinopharm vaccine at a cost of USD 10, or Tk 850, per dose. Initially, government sources revealed this information. No further information on whether any cheaper or more expensive vaccines were procured later has been made public. Let's assume that the subsequent vaccines have been procured at USD 10 per dose.

Bangladesh has used its own aircraft to transport the vaccines from China. Thus, transportation costs will be added to the USD 10 price tag. Bangladesh also acquired vaccines from the COVAX consortium, but it is not clear whether it bought the vaccines at a subsidised price or got them for free.

On July 3, after 25 lakh doses of Moderna arrived at the airport, the foreign minister and the health minister informed that these vaccines were obtained free of cost. Now, some sources at the government are claiming that these vaccines were procured at a cost of USD 2 per dose. Let's assume that Bangladesh bought the vaccines from COVAX. Still, the Moderna and Pfizer vaccines procured from COVAX should cost less than Covishield, including carrying costs.

But the health ministry has insisted in its advertisement that it procured each vaccine dose at a price of Tk 3,000, which equals to USD 35 or 36.

Thus, even if we did buy the vaccines from COVAX, there is a huge difference in the amount claimed by the health ministry. And if it received the doses free of cost, then too there is a huge anomaly in the monetary calculations as well as a discrepancy in the amount of vaccines. Now the question is, what is actually going on with the vaccine procurement? Why are there so many questions and allegations of anomalies and discrepancies in the calculations made by a government agency? All of this clearly points to massive corruption.

As there is a 25-30-dollar gap in pricing, the allegation is serious and should be treated as such. The gap in the amount of money shown is humungous. If the health ministry does not clarify this issue, it will only further support past allegations of corruption against the ministry. 

The health ministry has informed us that it has treated one lakh Covid-19 patients so far. Each patient had to stay in hospital for an average of 10 days. Every day, the health ministry spent Tk 20,000 for each patient, with the total costs for treatment reaching Tk 2,000 crore. Although one can raise a question about the average hospital stay period of 10 days, let's assume that the health ministry's version of the events is accurate. Even then, questions remain about the daily expense of Tk 20,000 per patient, especially when hospitals in 35 of the 64 districts are totally deprived of ICU facilities. How does this justify the total expense of Tk 2,000 crore for Covid-19 treatment purposes? This is a serious question and should be investigated with due importance.   

 There can be many other questions about the authenticity of information used in the advertisement, but the above discussion should drive home the point we're trying to make. Will the health ministry respond to these questions or complaints?

Golam Mortoza is a journalist at The Daily Star. This article was translated from Bangla by Mohammed Ishtiaque Khan.