Thursday, August 6, 2020

Coronavirus Tsunami: Will everything be all right in Botswana?

We have all heard the expressions, “A lack of planning on your part, does not constitute an emergency on my part.”While that may hold true for an individual situation, it does not hold true when dealing with a disease pandemic.The Covid-19 has triggered an unprecedented crisis in human history. Everyone and every country is trying to play catch up. When new threats to human life arise, anxiety, needs and expectations are high. Policymakers require information quickly that will inform risk assessments and potential counter measures. The failure of a government to conduct the necessary planning in order to be prepared to provide a competent and effective response to a predicted inevitable event, such as a disease pandemic, becomes an emergency for all of us.The public likewise, demands transparency and trust and assurance that the actions taken by all those involved including politicians, scientific and public health officers are guided by overarching concerns about global health.

Research has demonstrated that in the past decades, the emergence of new infectious diseases has shaped not only medical concepts, but also those of science and public health, affected political responses at global, regional and national levels. It had serious economic impact and influenced the anxieties and expectations of the public. The Covid-19 adds another such disease and its impact may be understood in such a historic and global context.In the 1980s for instance, the emergence of the HIV/AIDS had an enormous impact on medicine, science, politics and society – an impact that is still unfolding. The concerns raised by HIV/AIDS changed the relationship of patients to their disease and treatment. It provided the clearest example, to date that a disease has the capacity to become a globally transforming political issue, affecting national & intentional relations.There was also the emergence of the Severe Acute Respiratory Syndrome (SARS) in 2003 which affected 23 countries, which demonstrated the speed at which infectious diseases in the globalized world can move beyond its local origins to become crisis affecting the health of people & economics by reducing international travel and trade.SARS became a fundamental test case and driving force for countries to reshape the International Health Regulations (IHR).

The regulations which came into force in 2007, are an acknowledgement that all countries are at risk from certain threats, such as a new infectious disease with the potential for international spread.The IHR also stress the need for a proactive approach by affected countries and the need for transparency in reporting. This approach encompasses prevention, containment, investigation and timely reporting. Furthermore, in 2011, a new fundamental Public Health agreement called the Pandemic Influenza Preparedness (PIP) framework was adopted. This framework pertains only to Influenza viruses but reflects the large concerns of Members of WHO, including Botswana.It is on the basis of this that we have seen WHO developing the Global Action Plan for the Covid-2019 response and the roll out to its member states with its clean hands campaign and social distancing at the center stage. Will the new Corona virus be worse?The 2009 H1N1 Influenza pandemic demonstrated  that a global outbreak of even a relatively mild disease could overwhelm the capacity of many countries to respond and raised a number of issues, along with the rapid pace of development and enormous amounts of information and mis-information, politicians and aided in particular by the different social media platforms created significant levels of district and anxiety among countries.

The pandemic has eventually underscored that Botswana’s health system needs serious reforms post Covid-19. Botswana’s medical care delivery system is not set up to respond to pandemic surge. Unfortunately, Botswana is now paying the price for failing to properly plan in terms of the lessons learnt from the HIV/AIDS pandemic and other diseases. The Tsunami wave from the Covid-19 will hit Botswana’s health care system much more, which calls for an urgent need to train health care professionals, nurses, counsellors, policy analysts and health care administrators.The outbreak of the Covid-19 has demonstrated that there is urgent need for human capital development in various areas of health training such as health policy analysis, health economics, health informatics, health and logistics and health care service delivery / health care financing. Heavy reliance on general practitioners and physicians who are not trained in robust training on public health and policy needs to be looked into going forward, there is currently a serious gap.The. Institute of Health Sciences also need to be reformed, these institutions must be capacitated to provide quality health care training. Their training courses must not only meet the national accreditation with BQA but must also meet the global standards and should be affiliated with other Universities in the region and globally offering these health courses as opposed to take them to fly by night institutions that have been set up chasing the government purse.

It will also assist in sending less students to those so-called privately-run institutions that are 100 percent depended on government funding.Post Covid-19, there will be a compelling need for the University of Botswana to establish a Centre for Global Health, which can be housed at the Sir Masire Hospital or at the Faculty of Health Sciences. This center will spearhead training program on health policy analysis, global health, health diplomacy and politics, health economics, health informatics, logistics and health, health care financing and epidemiology. The stereo type mentality that this is the preserve of public health is driven by naivety and should be a thing of the past. BIUST can also invest in Medical health technology and offer training modules in Medical Tech and may work closely with industry players and not with fly by night business Men and Women who have entered this space for money opening a window for corruption.Unbelievably, even as the virus continues to spread widely globally and with new cases of local transmissions in Botswana, people are still queuing for permits and are still dismissive on the seriousness of the virus. The reality is that if the government of Botswana was to relax and bow down to un-necessary political pressure the disaster the country is currently dealing with, the worst will come as Covid-19 will spread even more rapidly and widely, causing more deaths. Botswana’s health system will not be able to care for patients, as well as those requiring non-Covid-19 medical care.

This will prolong the disease and will also prolong and deepen the economic situation.There will also be an urgent need to address the issue of Brain drain which is likely to arise post Covid- 19. However, the fundamental question to ask is how can brain drain be converted to into brain gain?  What policies can be adopted to stem such movements from developing countries to developed countries. The push and pull factors in the journey of hope – what mitigating factors should be put in place to address the brain drain and benefits to be derived from brain gain. The recent episodes in Botswana and South Africa have been a fiasco. South Africa for instance used the apartheid skoop en dornoor approach in their early response to the Covid-19. In Botswana, we have seen how dis-honest and dis-respectful some politicians can be. In just less than an hour after they were expected to be in quarantine a video of them on a shopping spree went viral, including the opposition Spin Doctor, Rre Pono Moatlhodi, who later wrote and issued a lousy and clumsy apology.

An attempt was also presented to use Science as a reasonable justification in the political deliberations that went on in Parley by making reference to the incubation period of the Covid-19 cycle. The Scientific – Mis – Information threw some opposition fanatics into a wild a party. Un- be known to them this was just cheap political grand standing by making reference and using science as an excuse. In their celebratory mode, the unfortunate un-suspecting victims as well as naive victims threw lock down parties. The new research on the Covid-19 disputes the scientific arguments presented by the MP. The incubation period, the time between catching the virus and beginning to have symptoms of disease suggest that if you haven’t developed the symptoms by day 12, you could still be spreading the virus. In day the second day the arguments had shifted from science to political begging.

*Thabo Lucas Seleke is Researcher and Scholar of Global Health Policy Analysis

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Sunday Standard August 2 – 8

Digital copy of Sunday Standard issue of August 2 - 8, 2020.