The future of Botswana’s public health is a mixed bag: the African Development Bank (AfDB) says that while the country faces a lower overall disease burden, its incidence of non-communicable diseases (NCDs) will increase.
Botswana is in a category of countries (13 in all) where between 2022 and 2030, NCDs will dominate the overall disease burden (74 percent) while communicable diseases will decrease by 45 percent. Injuries will decrease by 8 percent and by 2030, the total disease burden will be 24,045 DALYs per 100 000 people.
“DALYS” stands for disability-adjusted life years and one DALY represents the loss of the equivalent of one year of full health. DALYs for a disease or health condition are the sum of the years of life lost to due to premature mortality and the years lived with a disability due to prevalent cases of the disease or health condition in a population.
The AfDB say that while Botswana will face a lower overall disease burden, it must adapt its health services to new challenges, related predominantly to NCDs. The latter include cardiovascular diseases (17 percent of the total disease burden), mental and substance use disorders (12 percent), and musculoskeletal disorders (9 percent). The Bank says that as a rule of thumb, as countries develop, the burden of communicable diseases declines while NCDs increase. As a result, health services and infrastructure need to adapt accordingly.
Preliminary findings that were presented at an NCD investment case in July last year suggest that the economic cost of NCDs to the Botswana economy is P13.2 billion per year – which is equivalent to 5.92 percent of the country’s annual GDP. Hidden costs from premature mortality and lost productivity (absenteeism and presenteeism) are almost five times higher: the cost of presenteeism alone (P 2.6 billion) is 4 percent higher than the total health expenditures on NCDs. Health minister, Dr. Edwin Dikoloti, has stated that NCDs are now estimated to cause 46 percent of all deaths in Botswana.
During a recent meeting of Parliament’s Public Accounts Committee, Jwaneng-Mabutsane MP, Mephato Reatile, raised concern about the drug problem and the harm that it is doing to young people, especially those living in Gaborone’s exclusive residential addresses. The MP said this when the Committee was considering a report tabled before it by the Director General of the Directorate of Intelligence Services and Security, Peter Magosi. His particular concern was that despite the fact that Gaborone was awash with drugs, no arrests are ever made. In response, Magosi promised that before the end of this year, DISS will make major arrests of those involved in drug trade. AfDB’s projections are that substance use disorders will rise by 12 percent between 2022 and 2030.