Firstly, it would be interesting to know exactly what Dr Setlhare knows of Botswana health policy apart from generalisations. Secondly, according to him, Botswana's policy has been "frozen" in the primary health care model since the Alma Ata declaration of 1978. Well, I have not been involved in Botswana policy making for the last 11 years, but I know that the Primary Health Care(PHC) model is still the most respected model worldwide. What he needs to understand is that the PHC model has by no means been frozen, in Botswana and elsewhere. It is dynamic and has undergone reform after reform over these last thirty years. Perhaps Dr Setlhare should familiarise himself with global literature on Health Systems Development before he demonstrates that he is the one who is actually frozen in time.
Health policy conception and formulation is an extremely dynamic area. I myself have advocated a more articulated written policy and legal framework for Botswana's health care system. I am aware that, following the short policy document produced in the early 1990s, Botswana has not produced a more detailed articulated Health Policy and Health Sector Strategic Plan as is now the practice in international health. I have advocated for some time that Botswana takes this path.
