For this past week I have been on bed rest and decided to retreat quietly to my farm where there is peace and the only noises I get being from different bird’s species. Whenever, I am there I find peace and comfort away from the city noise, thuggery, immoral practices and pollution.
In any case I used most of the time to catch up with the latest happenings globally.
When I was studying in Boston, MA in the USA specializing in Global Health and Management as an outfit of Public Policy after I was awarded the prestigious Fulbright Scholarship by the USA government. I had an opportunity to serve as a volunteer in the USA 2012 Presidential elections in New Hampshire under the Obama team.
Why I volunteered under the Obama team?
Former President Barack Obama just fascinated me. His health care policy that ensures Universal Health Coverage was something out of this world. It made me to easily fall in love with health care policy and health systems strengthening which later landed me at WHO, Geneva headquarters and later in Cape Town on a prestigious PANGeA PhD Scholarship with a focus on “Agenda Setting and the need to introduce health care reforms to address issues of Non Communicable Diseases in the country.
Although measures have been put in place to address NCDs in the country, we are still lagging far behind. There is more of talk shop with no clear policy agenda put in place. And yet they are silent killers. There is no funding available for NCD in Botswana, no prevention and health promotion -a closer look on Botswana’s profile of NCD on the WHO website clear shows that.
I do not want to start by trumping it up, but in Botswana our body politics or rather than our political leaders are more focused on pretending to be very busy with their township walks as if they are of any value. They are more consumed on careless spending, un-necessary acquisitions of military hardware than on health investment.
Many may disagree with me inclusive of those high ranking top officials who have no shame just to give someone an irritating and disturbing telephonic call on a Saturday morning just to tell me off and issuing out threats using their position.
This is also a bitter pillow to swallow, especially to those BDP slaves, scared irresponsible party elders (dinosaurs) and parrots. Their leader has been a complete flop right from April fool day 2008. When I saw that evolving, I could only sympathize with him, for he had also surrounded himself with dangerous, cruel and ruthless parasites, blood suckers who suddenly think they have made it in life and have suddenly become extremely arrogant and pompous, including former spanner boys, staff nurses and lorry drivers.
A random walk into a Public health care facility in Botswana is an eyesore, with no drugs available coupled with sometimes de-motivated health care workers. Making endorsement by WHO, the World Bank, and the UN’s Sustainable Development Goals, the drive towards universal health coverage (UHC) in Botswana is just a wishful thinking and daily cheap workshop talk.
A closer look and analysis on the USA American President Donald Trump’s first 100 days agenda on health and lessons to be learnt.
The first 100 days of a presidency are often taken as a measure of initial success and an indicator of the future potential of an administration. By this standard, the first days of President Donald Trump present a bleak outlook. In many respects, the most important features of the Trump Administration so far are the things that have not happened. The repeal of the Affordable Care Act (ACA), a central campaign promise of the Republican Party, collapsed under the weight of logical inconsistencies in the Republican promise: that their plan could provide better health-care coverage, to more people, more cheaply, and cut taxes, all at the same time. Republicans remain divided between hardline conservatives who want repeal of the ACA, and more moderate factions who foresee electoral disaster from that path. The Republicans’ ability to make sweeping changes to the US health-care system, which makes up a sixth of the economy, requires a stronger hand and clearer vision than Donald Trump can offer.
But what the Trump Administration is not doing extends well beyond legislation. By the end of April, Trump has failed to nominate or even name hundreds of positions that have been left vacant since his inauguration. Dozens of people ordered to resignÔÇöambassadors, federal prosecutors, and administratorsÔÇöhave not been replaced. In most cases, Trump has not named successors, and it is unclear when the vacancies will be filled. Even where Trump has named someone for a position, confusion reigns. Scott Gottlieb, Trump’s controversial pick to head the Food and Drug Administration (FDA), and Francis Collins, Director of the National Institutes of Health (NIH) asked by Trump to stay on, remain in limbo, with Gottlieb awaiting confirmation, and Collins, acting as de facto NIH director, not knowing if someone else will be nominated. This kind of institutional confusion can be devastating for programmes and projects that unfold over years and require institutional stability.
The Trump Administration’s strongest statement about government is the so-called skinny budget, a budget blueprint put forth by the administration in March. A $54 billion increase in defense spending coupled with drastic and unprecedented cuts to discretionary domestic spendingÔÇöfrom the Environmental Protection Agency, Health and Human Services, and the FDA to programmes essential to health in the USA and abroad, including USAID and the Centers for Disease Control and PreventionÔÇöundermines the USA’s ability to respond to global health threats. Especially concerning are cuts to the NIH ($5┬À8 billion, 18% of its current budget), which specifically eliminate the Fogarty International Center, an initiative to build partnerships between governments and research institutions around the world, and train the next generation of global health scientists. With a budget of only $70 million, Fogarty provides invaluable experience for doctors and researchers from the USA and abroad. Although a strong campaign has been launched to protect Fogarty, close observers are anxious that Collins may sacrifice this critical part of NIH in order to protect other parts of the NIH budget
Trump’s budget proposal is unlikely to become law. Congress sets budgets, and Republicans are less concerned with ideology-driven reductions in government than in functioning programmes that constituents depend on. However, his budget does indicate his administration’s direction of travel. Based on current evidence, the Trump Presidency is no friend to science, medicine, or global health. By contrast, the elevation of Neil Gorsuch to the Supreme Court is a solid accomplishment for Trump. Gorsuch is the kind of conservative jurist that any Republican would have nominated, and his writings and opinions have given conservatives ample reason to cheer. However, anyone concerned for women’s reproductive health will only shudder at his nomination.
The first 100 days of Donald Trump’s presidency have shown that he has few fixed opinions about government functions, whiplashing from advocating universal health coverage to promising to actively sabotage the operation of the ACA to hurt the Democratic Party, and the many Americans who depend on it for health care. But whether Trump believes it or is influenced by the people around him, so far the idea of an empty government, robbed of its ability to perform its most basic functions, is sowing confusion and uncertainty about the current US Administration’s commitment to health, at home and around the world.
*Thabo Lucas Seleke is a Scholar and Researcher in Health Policy and Health Systems Strengthening.
