BONELA Responds To SONA 2015

Correspondent | Monday November 16, 2015 14:07

Botswana remains one of the few countries that have achieved the Abuja Declaration of committing at least 15% of its national annual budget towards health. This state of affairs is indeed plausible and desirable considering that Botswana remains one of the countries with high HIV burden which has a potential to reverse gains made thus far in socio, economic and political development.

While we acknowledge government’s commitment to improving health infrastructure, by committing to deliver quality care through revitalisation of primary health care, decentralisation of some decision-making processes to the districts, the expansion of operation hours in clinics from eight to 24hrs and increased private sector participation, it is however, not clear how government intends to address the challenges related to poor service delivery in the health system as well as poor performance of health care workers due to low morale. BONELA continues to receive cases related to medical malpractice and/or negligence as a result of poor adherence to medical standards of good practice and ethics. These cases are related to wrongful diagnosis, administering and prescription of wrong medications, mishandling of women during child birth resulting in avoidable mortalities, just to mention a few. We therefore call upon the government of Botswana to put in place robust systems that will ensure monitoring of quality of care as well as performance of health care providers. These will provide good indicators for the health sector performance.

While we acknowledge government’s commitment to attaining HIV/AIDS epidemic control by 2020, the apparent non-reference to human rights and addressing policy and legal barriers that inhibit access to HIV treatment, care and support services by key populations i.e. sex workers, men who have sex with other men and people living with HIV/AIDS as a key strategy to attaining zero new infections goal, is unfortunate and regrettable in light of the recent Botswana Behavioural Surveillance Survey of 2012(BBSS) which revealed a prevalence rate of 61.9% for sex workers and 13.1% for men who have sex with men. The HIV prevalence for sex workers is three fold higher than the national prevalence of 18.2%. Therefore, government’s commitment to a rights based approach to addressing HIV/AIDS among key populations should be reiterated during opportune moments like the State of the Nation Address (SONA).

BONELA welcomes the intensified use of treatment as prevention through test and treat approach and the increased access to antiretroviral treatment to all those who need it. However, with the increased costs related to treatment, which brings to the fore critical issues of sustainability, BONELA would have expected the address to highlight proposed strategies of sustaining the treatment programme in the intermediate and long term.

We reiterate government’s position that the ultimate answer to stopping HIV/AIDS lies in exercising self- discipline and behaviour change, however, we also note that an improved enabling policy and legal environment, improved service delivery, improved procurement processes, patientcentred approach to health are essential ingredients to self -efficacy and increased health outcomes.