In Bhutan, health indexes have significantly improved through the construction of medical facilities and Basic Health Units (BHU).However, some indexes such as infant mortality rate (IMR) and maternal mortality ratio (MMR) are comparatively high due to a shortage of manpower and lack of capacity. The IMR in 2006 was 54 (in 1,000 birth) and the MMR in 2005 was 440 (in 100,000 birth) (WHO Global Health Observatory). Bhutan aims to introduce ambulance services throughout the country and the existing old ambulances in Bhutan need to be replaced. In addition, although a Health Trust Fund was established in 1997 to purchase pharmaceutical products and vaccines, Bhutan still has to rely on donors for the purchase of vaccines. This highlights low functions of the public health and medical care systems.