#Budget2021 is NOT cutting health budgets. But it looks that way because the accounting treatment has changed.
1. Line Item 20000 is Services & Supply (see pic, in red). All are zeroes.
No Govt is so cruel/foolish to cut health spending to zero overnight. So where is the money?
2. The money is being reallocated from Operating Expenditure to Development Expenditure.
See pic of Services & Supplies, with 840% INCREASE in DEVEX & a 12% DECREASE in OPEX.
Two questions:
a. Why move from OPEX to DEVEX?
b. What is the breakdown in DEVEX, by category?
3. More questions:
a. How will you procure Services/Supply in DEVEX? Tenders, direct nego, direct purchases, Treasury Instructions? No transparency = corruption, wastage, fraud.
b. Headcounts remain flat at 267k (p381). Was there a discussion with MOH/JPA to increase headcount?
4. Overall, the health budget grows only 4.3% vs 2020. That’s not enough at all!
It’s inaccurate to say that “funding is drastically cut”. The accounting treatment to move from OPEX to DEVEX is unnecessary & confusing, & must be explained by the Govt.
/end
• • •
Missing some Tweet in this thread? You can try to
force a refresh
#Budget2021 is NOT cutting health budgets, but is irregular (Part 2):
The Govt is using a different accounting treatment for health spending (e.g. buying medicines, dialysis etc) by decreasing OPEX & increasing DEVEX. Why?
1. In our fiscal rules = OPEX can be financed by revenue; DEVEX by revenue or borrowing.
2. Revenue (tax, Petronas etc) is likely to decrease in 2021.
3. So it’s logical to shift health spending from OPEX to DEVEX, so we can borrow money to pay for health.
2/n
BUT DEVEX spending... 1. Is less transparent because categories are not visible. 2. Leaves room for “individual judgment” = more political influence or leakages. 3. Can use direct negotiations or direct procurement = no open tenders (this point needs Govt clarification).
3/n
This week, I'll share some fun vaccine facts because 🇲🇾 joined COVAX.
Fact 2: there are ~10,000 diseases but only ~1500 treatments & ~30 vaccines.
How many diseases have been 100% eradicated by vaccines? Only one: smallpox, declared in 1980. (1/6)
~10,000 diseases? It's a rough number because “disease” could mean different things.
One resource is the International Classification of Disease 10th edition (ICD-10), managed by @WHO. It has ~70K codes!
Some are hilarious, like this pic. These are not diseases, of course.
Diseases can be infectious (eg tuberculosis, malaria or HIV/AIDS) or non-infectious (eg diabetes, cancer or asthma). Another term is “communicable”. Vaccines work against communicable diseases.
3 of the top 10 global causes of death are infectious, so it's a big problem.
The COVAX Facility aims to provide fair & equal access to the Covid vaccine for 7.8 billion people.
To commemorate 🇲🇾's entry into COVAX, I'll spend this week on some fun vaccine facts.
Fact 1: Edward Jenner discovered the concept of vaccination in 1796, ~220 years ago. (1/6)
For many years, he heard stories that dairymaids don’t get smallpox if they’ve had cowpox previously. Dairymaids spend a lot of time with cows to make milk or cheeses in a dairy.
This pic is cowpox. (2/6)
A young dairymaid had fresh cowpox. Jenner transferred some material from her skin lesions to an 8-year old boy’s skin. The boy had some mild fever but was otherwise quite well.
2 months later, Jenner repeated with smallpox but the boy had no fever.
4. As 🇲🇾’s national Covid situation stabilises, it’s time to work globally to ensure that 🇲🇾 has equitable access to meds & vaccines when they are proven truly effective.
5. Decisions on Covid med prices must never be influenced by Wall Street or commercial considerations.
Difference between:
*Asymptomatic*✅Covid❌symptoms for entire disease. (~40-45% of all Covid cases). Therefore, 🇲🇾 might have ~14K total cases (not ~8K) because no symptoms = no test.
*Pre-symptomatic*✅Covid, but❌symptoms yet. Median time to symptoms: 4-5 days from exposure.
One final important note is that "science is evolving" and facts will continue to emerge. As the datasets grow bigger and we analyse them better, conclusions may have to be revised.
We're still learning about SARS even though it "ended" in 2003.