4th August 2022
Own Correspondent
The COVID-19 pandemic has brought to the fore the weaknesses of health systems in Africa and as such there is a need to invest in building more resilient health systems that are ready for the future revealed officials at the signing of a memorandum of agreement with the World Health Organization(WHO) to enhance adherence to International health regulations.
“Though the region has made tremendous progress guided by various global, regional and country conventions and frameworks, such as IHR, IDSR and National plans for Health Security(NAPHS), inadequacies in planning, limited trained human resource, lack of agility in response and challenges with stockpiling of supplies remains a challenge,” said Dr Josephine Namboze, World Health Organization(WHO) Country Representative.
She said, “In view of all these events, WHO continues to work with States Parties, Africa CDC and other partners to build African continent capacity to reinforce core competencies on implementation of the International Health Regulations(IHR). The aim is to ensure that countries have the capacity to adequately prevent, prepare for, detect, and rapidly respond to health emergencies.”
In accordance with recommendations from various WHO committees and the new global architecture to strengthen Health Emergency Preparedness and Response, WHO/AFRO has developed three flagship programmes to support Member States in the African region to prepare for, detect and respond to public health emergencies. These flagship programmes are:
- Promoting Resilience of Systems for Emergencies (PROSE) Flagship initiative that aims at ensuring that countries are better equipped to plan for health emergencies and humanitarian crisis
- Transforming African Surveillance Systems (TASS) Flagship initiative which its thrust is to enable quicker detection of public health threats through strengthening national capacities on IDSR and improve existing laboratory infrastructure and systems.
- Strengthening and Utilizing Response Groups for Emergencies (SURGE)- to ensure governments are equipped to mobilise and respond to public health emergencies within the first 24hrs of public health emergency.
These initiatives are the results of extensive consultations with more than 30 African government ministers, technical actors, partners across the continent including regional institutions such as the Africa Centre for Disease Control and Prevention, whose contributions have shaped the priority activities. This is to build on efforts made by multiple actors over the past decade to build strong Emergency Preparedness and Response (EPR) systems in Africa.
The whole mark of EPR Flagship Initiatives, is to ensure heightened Health Security in the African Region, build upon existing infrastructure to ensure a well-organized partner support system that augments national capacity when needed, as well as incorporating lessons learned from COVID-19, Ebola, and other health emergencies. initiatives that aim to promote multisectoral convergence of resources and skills for rapid and efficient response to emergencies and disasters.
Starting these initiatives initially in 15 countries, Botswana is one of the first five (5) countries that the SURGE and TASS initiatives are being pilot tested.
To operationalize the SURGE which is learning program to strengthen the capacity of countries by equipping a national multisectoral and multi-disciplinary team of Experts to be ready to be deployed in the country to support vulnerable populations, WHO was to successfully identify a team of 70 multidisciplinary and multisectoral team from national and subnational teams in Botswana.
They will be fully trained to be highly skilled, resourced and have completed the first part of training on emergency management capabilities through functional public health emergency operation center (PHEOC). This will enable Botswana to be able to prepare for and respond to public health emergencies
In December 2021, Botswana became the first high HIV burden country to be certified by WHO Global Validation Advisory Committee (GVAC) as having achieved the silver tier of “path to elimination of vertical HIV transmission officials have revealed.
“The Global AIDS report indicates that over 95% of HIV positive pregnant women in Botswana were receiving antiretroviral therapy (ART) in 2021, up from 77% in 2010. Vertical transmission rates were only 2.2%, down from 9.0% a decade earlier,” said Dr Edwin Dikoloto, Minister of Health and Wellness.
He said, “Botswana is among six countries in the Eastern and Southern African region that met the 90-90-90 targets for testing and treatment with an achievement of 93-96-98 in 2020 and almost 93% of people living with HIV know their status, 96% of people living with HIV who know their status are on ART and 98% of those on ART are virally suppressed.”
In June 2016, the country made a policy decision to adopt the Treat All strategy which set the country on the path to reaching and surpassing the UNAIDS 90-90-90 targets and almost reaching the 95-95-95 targets 8 years ahead of time.
As at 2021, Botswana was already at 95-98-98 success rate. Botswana has always been a trail blazer in following and adopting global guidance on ART treatment and therefore, joins the global community in welcoming the move towards the generic production of Long Acting PrEP.
In 2019, Botswana made yet another positive move to extend free ART to non-citizens for free.
“The global community has welcomed the historic decision wherein Botswana decriminalized same-sex sexual relations in a court of appeal in November 2021. This made the country the second to do so in Africa after South Africa which did so in 1999,” said Dikoloto.
UNAIDS has commended the leadership of the First Lady of Botswana in championing Adolescent Girls and Young Women issues. The First lady of Botswana, Mrs Neo Jane Masisi, is the UNAIDS Special Ambassador for the period July 2021 to July 2023.
Despite these noble achievements, some challenges still remain. These relate mainly to preventing and detecting new HIV infections, including among pregnant women. Again, the country’s success of the PMTCT program has not necessarily translated into high ART coverage for children, where only 69 percent of them are on life saving treatment compared to 92% among adults.
Dikoloto, “Gender disparities in access to HIV services also remain a challenge that we should do everything in our power to confront head on. We should adopt innovative approaches to help especially men, young women, Key Populations, and children, to access essential health services, in order to prevent new infections among these groups.”
