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Bonela Responds to the State of the Nation Address (SONA)

Publishing Date : 14 November, 2017

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President Lt. Gen. Dr Seretse Khama Ian Khama delivered a one dimensional appraisal of the health sector in the past year, going back into his decade in office. Botswana Network on Ethics, Law and HIV and AIDS (BONELA) acknowledges the achievements as captured in the State of the Nation Address (SONA) but wishes the President had gone further in appreciating the downsides, which if unacknowledged could recur and become resistible to future interventions.

The government’s efforts in infrastructural development as well as improved facilities such as the increase in the number of 24-hour health facilities; the reportedly 84% of the population having access to basic health services within 5KM radius and the construction and upgrading of 31 clinics and health posts is commendable. BONELA is however concerned that the SONA was mute on the challenges that besieged the health sector in the recent past.

There were reports of unavailability of essential medical commodities and equipment such as drugs, reagents, masks, gloves etc. In our view, the President should have acknowledged these realities especially that we may not know direct and indirect impact of such occurrences on sustainable health and wellness of Batswana.

In 2017, an infamous and controversial Public Health Policy Savingram; announcing Government intention to deny medical treatment to patients with particular lifestyle, was circulated in the public domain. The policy draft was later withdrawn after public outright disapproval, including threats of law suits. The government communique put to shame what the President, in his SONA, said is the government’s Health-in-all- policies approach which is expected to cut down health inequities.

The President needed to have acknowledged the government’s blunder as well as assure the nation that such a policy or anything similar will never see the light of day. BONELA has always advocated for ethical health in line with the known health for all principles, which, although our constitution is not explicit about, remain the corner stone to any successful health service.

BONELA has discovered, through its work on Human Rights and health, that there is still a lot that needs to be done to ensure equitable access to health services in Botswana. The fact that the constitution of Botswana is not categorical about second-generation rights, which would include the right to health, means that people’s legal access is already compromised as relying only on the right to life provision is inadequate. It is disappointing that like his predecessors, the president leaves without amending this constitutional anomaly.

BONELA also learnt, through its work that service providers like health practitioners, social workers, and the police need capacity building on ethical and human rights based approach to their work. This will enables improved access to services, particularly for Sex Workers, Lesbians, gays, bisexual, transgender and intersex as well as adolescents and young women.

The president also noted with concern, the increasing prevalence of non-communicable diseases, with 31% of the population reported to be overweight while 11% were reported to have raised cholesterol levels. According to the SONA report “over 70% of cancers are diagnosed at advance stage which significantly lowers the chances of cure and long term survival”. BONELA applauds the government for recognising this emerging epidemic by developing a multi-sectoral strategy to address Non Communicable Diseases and their risk factors. BONELA therefore calls on the Ministry of Health and Wellness to work closely with civil society organisations, through models such as Social Contracting to ensure improved health outcomes at individual and community levels.

BONELA wishes the president a peaceful retirement and hope that he will use the remaining five months to encourage a paradigm shift in government policy approach. With ethical and human rights considerations, the government would be able to influence both behavioural and attitudinal change towards better health seeking behaviour. The addition of the word wellness in the ministry’s name as well as acknowledgement of the preventive over the curative approach will go a long way in creating sustainable health solutions



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