Thursday, April 25, 2024

A retreating America will add pressure on Botswana’s already weakened public health system

Over the years the government of Botswana has benefitted immensely from the generous patronage and assistance of the United States government especially in the fight against HIV/AIDS.

The partnership which has endured for over two decades was craftly wrought together by the then president, Festus Mogae.

At the time president Mogae was deliberate and systematic in his thinking that for Botswana to emerge victorious over HIV/AIDS the public and private sectors needed to cooperate.

In that score he was able to attract assistance for Botswana from such diverse organisatioons like Bill and Melinda Foundation, UNAIDS and the PEPFAR.

It is hard to see how such a coalition can be achieved today in the days of growing nationalism and recoiling globalization.

HIV/AIDS reached its height during that time and at one time, president Mogae thought aloud that Botswana was facing annihilation.

This week the outgoing United States Ambassador in Gaborone told a group of journalists that going forward the American government will step a little bit backward from the frontline in its assistance to Botswana on the health and medicine front.

Ambassador Craig Cloud said America will pivot towards providing technical aid.

This is not a small announcement. It is big, as it will become apparent over the next few months as the new strategy begins to take shape.

This means that the United States involvement will be limited to such things like data and analysis of such data instead of frontline activities.

This is problematic for Botswana.

The country is currently is the cusp of a major economic crisis owing in no small measure to Covid-19, which has also decimated the public health system.

In other words the United States has chosen to exit the frontlines at a time when their services are as much needed as they were when former president Mogae used to frequent America there to plead and beg the American authorities to come to Botswana’s aid.

Clearly the Americans believe that Botswana has very strong systems in place that can carry on now without their direct assistance.

We beg to differ.

This is exactly what happened to Botswana two decades ago when many development partners left the country because the country was now a middle income country and felt their help was much needed elsewhere.

That mass exodus of development partners set Botswana back in a very big way.

Batswana felt like they were being punished for their efforts to behave well and push their country forward when everybody else was misbehaving.

Botswana government had grown used to the immense assistance from the United States.

And it will take a while for Botswana to be able to wean itself away from the hands-on and frontline involvement of the United States.

We say this even as we are aware that throughout the HIV/AIDS fight, Botswana government has always the one doping the heavy lifting especially on the purchase of the anti-retroviral drugs that cost billions of pula every year.

Botswana has become a global leader in the fight against HIV/AIDS owing in no small measure to the assistance from the United States.

That assistance was multipronged.

It could come in the form of mass testing for HIV/AIDS. Or in some time as the fight shifted it could be in the form of male circumcision campaigns.

In other instances the focus would shift towards fighting tuberculosis and all its related evils as it became clear what a devastating partnership TB and HIV/AIDs had become.

The idea was always to strengthen the country’s public health infrastructure.

Fighting HIV/AIDS in different ways has for a long time been the flagship of the partnership between the United States and Botswana.

As a result, and this much was also said by Ambassador Cloud, Botswana is today a global leader in fighting HIV/AIDS.

He said during his time as U.S. Ambassador, Botswana made tremendous strides in health the UNAIDS 2030 goals nearly a decade ahead of schedule.

This is indeed commendable. It is sufficient testimony of what well established partnerships can achieve.

Today mother to child transmissions are also significantly low in Botswana, also thanks to a partnership between Botswana government and the United States.

This is what the Ambassador had to say, “In 2021, Botswana became the first high HIV burden country to attain Silver Tier status and is poised to eliminate mother to child HIV transmission entirely!”


Read this week's paper