28th August 2023
Sello Motseta
President Mokgweetsi Masisi has expressed his profound satisfaction at the decision of the Special Session of the World Health Assembly in November 2021, to launch negotiations for a pandemic treaty under the auspices of the WHO.
“Parallel to this work are the amendments to the International Health Regulations (2005) which all aim to strengthen global health security. Another important process that is aligned with these two, is the High-Level Political Declaration on Pandemic Prevention, Preparedness and Response, which is expected to be endorsed by the United Nations General Assembly this year,” said President Mokgweetsi Masisi, in official opening remarks at the official opening of the Seventy-Third WHO Regional Committee meeting.
He said, “We are indeed aware that all these global agendas have tremendous potential to set the tone for international legal obligations for preparedness and response to future health emergencies and pandemics. For these reasons, I wish to emphasize the need for the processes to be guided by the principles of equity, inclusivity of all Member States as well as international collaboration and solidarity.”
According to officials, the inequities in access to vaccines, PPE and medicines during the COVID-19 pandemic will probably remain one of the major failures of the international community in the 21st Century. In a globalised and highly interconnected world, the health concerns of developing countries should be a concern of the developed countries as well. Diseases have no borders, pandemics are global and therefore, the risks to one country invariably affect another.
The international community was encouraged to work harder to ensure a multilateral governance mechanism is in place that will result in equitable access to vaccines, medicines, diagnostics and other medical products and tools.
Officials say African Heads of State at the level of the African Union have prioritized diversification of local and regional pharmaceutical production. The pandemic instrument must support regional efforts and ensure the transfer of knowledge and intellectual property, well trained human resources and financing for the sustainability of the pharmaceutical production facilities, which should all be anchored on a well-functioning health system.
Botswana supports the need to maintain adequate regional stockpiles of pandemic health products such as vaccines, diagnostics and other necessary medical products while avoiding hoarding of such products by wealthier countries.
There is also a need for Instruments to have governance and accountability mechanisms, including respecting the WHO guidelines and the International Health Regulations in terms of travel and trade.
Officials recalled in November 2021, when Botswana and South Africa first identified and reported a new variant of SARS-CoV-2, some WHO member states immediately imposed travel and flight restrictions on several Southern African countries.
It undermined efforts to report pathogens and outbreaks of diseases in a transparent and timely manner.
The World Health Organization has reported that in order to achieve SGD 3 – healthy lives and well-being for all ages – the sub-Saharan African countries will need to spend, on average, 7.5% of the region’s Gross Domestic Product, or US $271 per capita per year on health. Currently on average Sub Saharan countries spend US $189.00 per capita per year on health.
Many countries in the Africa Region are on average, still far from meeting key health financing goals such as the Abuja Declaration target of allocating 15% of the Government budget to health. We note with concern that out-of-pocket expenditure is still higher than 40% of the total health expenditure in many countries according to the report by the High-Level Task Force on Innovative International Financing for Health Systems (HLTF).
“I also wish to appeal to the developed countries and development partners to align their funding with regional and national priorities including reducing conditionalities on voluntary contributions. Indeed, removing conditionalities and allowing more flexibilities in spending has the potential to unlock the much-needed financial resources that will enable WHO to cross fund other broad priorities, hence provide adequate leadership and technical support to countries,” said Masisi.
He said, “The World Health Organisation(WHO) plays a central role in global health governance, and is an important partner in the region in advancing health outcomes in pursuit of the goal of attaining universal health coverage by 2030 say Botswana officials.”
In Sub-Saharan Africa, the average life expectancy at birth increased from 58 years in 2011 to 61 years in 2019. This was as a result of improvements in the provision of essential health services, which improved to 46% in 2019, compared with 24% in 2000.
Furthermore, gains in reproductive, maternal, new-born and child health, as well as progress in the fight against infectious diseases—rapid scale-up of HIV, tuberculosis, and malaria control measures from 2005, were a result of improved provision of health services.
“I also take this opportunity to acknowledge some noteworthy successes in the advancement of the health agenda, including eradication of smallpox, certification of wild poliovirus in 2020, managing health emergencies such as Ebolavirus disease, elimination of some neglected tropical diseases, while also dealing with the increasing burden of hypertension, diabetes and other non-communicable diseases in the Region,” said Masisi.
He said, “The importance of fast tracking our health SDG targets as well as to build forward and strengthen our health systems cannot be over emphasised. The WHO has estimated that around 47%, or US $ 796 billion is lost in productivity value, which could be avoided if we can meet our health Sustainable Development Goals.”
Just as in the Constitution of the WHO, In Botswana we recognise that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition”.
With respect to public health financing, the Government of Botswana is funding about 80% as a share of domestic health expenditure. For instance, for the 2023/24 national budget, the Ministry of Health was allocated the largest share of the recurrent budget at about 17.1%, which was particularly important in the wake of the COVID-19 pandemic.
It will be noted that in Botswana, only about 4 % of the total health expenditure is generated through out-of-pocket payments, which remains one of the lowest globally.
Some of Botswana’s recent successes include certification through a Silver Tier Award for Botswana on eliminating mother-to-child transmission of HIV by the World Health Organization. We have also achieved and by passed the UNAIDS 95‐95‐95 targets to help end the HIV epidemic by 2030. In Botswana 95.1% of adults (15‐64 years) living with HIV are aware of their HIV status; 98 % are on ART care and 97.9% are virally suppressed.
Botswana is on the path to eliminate malaria, having sustained a low incidence rate of below 1 per 1000 population in the last five years. Through the WHO Global Malaria Programme of E-2025 initiative, Botswana is one of the countries that are fully committed to malaria elimination by 2025.
Dr Tedros Adhanom Ghebreyesus, World Health Organization(WHO) Director-General, observed, “Botswana reached the 95-95-95 targets for testing, treatment and viral suppression of HIV – one of only five countries to do so. In the fight against cervical cancer, Botswana was among the first
countries in the region to introduce the HPV vaccine. It is also one of the few countries to have a high vaccination coverage for COVID-19.”
He said, “Over the past six years, WHO has undergone the most significant transformation in its history. We have made major changes to our processes, our operating model, our financing, our approach to partnerships, our workforce and our culture.”
Ghebreyesus outlined five priorities – the “Five Ps” – which are now becoming the basis of GPW14: to promote, provide, protect, power and perform for health.
The first priority is to promote health and prevent disease by addressing its root cause by taking very strong action to reduce tobacco use and harmful alcohol use; making diets healthier by reducing salt and sugar intake; increasing physical activity, improving water, sanitation and hygiene and addressing air pollution, and climate change.
According to WHO officials, at least 15% of health facilities in Sub-Saharan Africa have no access to electricity at all, and many more have unreliable access. This means surgeries and births are done in the dark, vaccines cannot be stored safely, and that vital medical equipment cannot function.
The WHO Secretariat is supporting African Member States on electrification of health facilities through decentralized solar energy systems.
Maternal and child health also remains a major challenge with an estimated two-thirds of maternal deaths occurring in Africa.
