In his letter of 8th February replying to mine of a few days earlier, Dr Setlhare maintains it was not a personal attack on me that I was replying to, but I maintain it was. That is why I felt I should reply. If you accuse somebody of having perpetuated a policy of no-dialogue, and you really cannot prove that, then you are attacking them. I served the Botswana health service for 21 years, the last seven as PS, and retired at the end of 1996. I would challenge anybody who would argue that I was not a consulting manager.
Let me come to the issues. My young colleague accuses me of assuming that when I speak God my word should be taken as that of a God. Far from it, I am a great believer in exchange of ideas. In fact in health policy making, there is no space for dogmatism, because although best practices and policy guidelines are drawn up, each situation is different. The Alma Ata declaration was a broad guideline, each country proceeded to draw up its own Primary Health Care [PHC] policy and practice based on its own situation on the ground, including its own philosophy on social services. The broad principle of PHC as enunciated in Alma Ata was health services accessible to the whole population, taking into account the impact of other sectors, involving communities, and delivered in a way that the communities and the countries could afford. These were broad principles which countries tried to apply in their policy-making for their health sectors and their development in general. I doubt if anybody would really fight with these principles.
