Arya News - A mid-level officer earning a basic salary of Nu 30,000 (USD$310) contributes Nu 300 (roughly USD$3.11) every month through the mandatory one percent health contribution. That amount alone is enough to provide four doses of the pentavalent vaccine, protecting four newborns against five life-threatening diseases.
THIMPHU – A mid-level officer earning a basic salary of Nu 30,000 contributes Nu 300 every month through the mandatory one percent health contribution. That amount alone is enough to provide four doses of the pentavalent vaccine, protecting four newborns against five life-threatening diseases.
While the deduction appears as a small figure on a monthly payslip, it is one of the key sources of funding that ensures Bhutan’s uninterrupted supply of essential medicines and vaccines.
Each month, one percent of every employee’s basic salary is deducted and channelled into the Bhutan Health Trust Fund (BHTF), which acts as custodian of the contributions.
The BHTF uses the fund to sustain the procurement of essential medicines and four vaccines that are provided free through the country’s public healthcare system.
Yet according to BHTF Director Dr Gembo Sithey (PhD), most contributors have little idea where their money ends up. “People need to know where their money is going, and if they do, it can encourage them further.”
Roughly 3,300 agencies, entities and organisations contribute to the fund. These include, among others, the Royal Civil Service Commission, the armed forces, financial institutions, corporations, business enterprises, the construction sector, travel agencies and constitutional bodies.
Around Nu 400 million is generated annually through the one percent health contribution. The money is collected by the Ministry of Finance, which transfers the funds to BHTF every month. The Trust Fund does not collect the contributions directly.
Currently, the BHTF holds a total of Nu 4.3 billion, with 70 percent allocated for the procurement of essential medicines and vaccines. However, expenditure continues to rise as the list of medicines expands following the National Essential Medicines List review, which is carried out every two years. The increasing number of medicines and their costs result in an annual expenditure of around Nu 600 million.
Bhutan’s essential medicines currently comprise 438 allopathic medicines and 110 traditional medicines. Based on the 2024-25 budget, vital medicines account for 26.3 percent of the expenditure, essential medicines account for 28.3 percent and necessary medicines account for the remaining 45.4 percent.
The fund also finances vaccines for children, adolescents, and the elderly. During 2024-25 fiscal year, the BHTF procured 46,200 doses of pentavalent vaccine at Nu 126 per dose, 48,400 doses of the pneumococcal conjugate vaccine (PCV) at Nu 266 per dose, 80,000 doses of the influenza vaccine at Nu 326 per dose and 14,000 doses of the human papillomavirus (HPV) vaccine at Nu 436 per dose.
The vaccines reached about 41,000 elderly people through the influenza vaccination programme, 8,900 children received the pentavalent vaccine and 5,600 girls and boys were vaccinated against HPV during 2024-25.
These efforts contributed to a nationwide vaccine coverage of between 97 and 99 percent
The impact of the monthly contribution varies little in amount but translates into tangible health benefits. A low-grade employee earning Nu 12,000 contributes Nu 120 each month, enough to provide 1.7 doses of the HPV vaccine, helping protect a girl against cervical cancer. A senior-level officer earning Nu 60,000 contributes Nu 600 monthly, which provides eight doses of the pneumococcal conjugate vaccine, protecting eight babies against pneumonia.
Dr Gembo Sithey said the health contribution reflects Bhutanese values of compassion and collective responsibility.
“In our tradition, we offer butter lamps, incense and prayers to accumulate merit and protect the lives of others. The one percent health contribution does the same, silently, every month,” he said. “Without lighting a lamp, without performing a ritual, your contribution buys a vaccine that saves a child’s life. That is merit. That is compassion in action.”
For thousands who see one percent disappear from their salary each month, the sum may seem trivial, but collectively, it keeps the medicines and vaccines flowing that protect the health of an entire nation.