Botswana is being advised to prioritise investment in health systems in national budgets in order to achieve the Abuja Declaration commitments. This follows details contained in the 2020 Gender Protocol Barometre which highlights that Botswana’s health expenditure as a percentage of total government expenditure was 9.1% which is lower than the Abuja Declaration goal of 15%.
On 27 April 2001, African Union countries met and pledged to set a target of allocating at least 15% of their annual budget to improve the health sector. Over the years, African countries have increased the proportion of government expenditures allocated to health, but some reduced it. Botswana’s 9.1% health expenditure mentioned in the Gender Barometre seems a backtrack from 2007 when Botswana along with Rwanda and Djibouti met the 15% target.
The report also damned Southern African Development Community (SADC) countries for spending “less than 10% of their GDP on health” except for Eswatini and Madagascar which spent 15.25% and 17.8% on health respectively, making them the only two countries to meet the recommended Abuja Declaration goal. The report also highlights that DRC and Comoros allocate the least to health at 3.7% and 3.6% of their respective budgets.
“Most countries will have increased health expenditures during the COVID-19 pandemic. It would be wise for governments maintain these higher allocations in years to come,” states part of the report.
A medical health expert, Kago Mokibe who spoke to this publication says whilst SADC countries have all drawn attention to the need for member states to adhere to the Abuja Declaration, the “coronavirus pandemic has laid bare the state of Botswana’s public health sector. With the numbers of Covid-19 local transmission increasing exponentially especially in Gaborone and Jwaneng, there is reason to be worried that the virus could overwhelm the country’s health systems,” says Mokibe.
Botswana is one among ten African countries which provide free and universal healthcare. However experts say Covid-19 is a jolt to Botswana to adequately invest in healthcare systems.
Experts use two measures to assess health financing: the level of health spending as a proportion of the total government spending and health spending as a proportion of a country’s Gross Domestic Product (GDP). The GDP represents the total value of everything produced in the country. It does not matter if citizens or foreigners produce it – if they operate within a country’s boundaries, research includes this production in GDP.