It is widely acknowledged that scientific knowledge is an essential driver for human health and wellbeing as well as economic development. Yet a number of African countries still only slightly fund research and development (R&D). Data shows that majority of African countries are still not able to meet the commitments made by the African Union (AU) on 27 April 2001, to set a target of allocating at least 15% of their annual budget to improve the health sector. While some African countries have increased the proportion of government expenditures allocated to health over the years, some have reduced it. Botswana’s commitment to the 15% target has been wobbling over the years and this has some medical health experts and policymakers worried.
The significance of investing in R&D has never been clearer. When the first case of Covid-19 was detected in China in 2019, Botswana along with majority of African countries failed properly respond and detect to the early signs of the outbreak. Most governments were reactive because they started fighting the virus after it had spread extensively in their territories. While there has been a quick development of different vaccines on all continents, Africa has been found wanting. The continent has 14% of the world’s population but only produces 0.1% of the world’s vaccines.
A research paper prepared by Emma Chukwuemeka, Okey Oji, Chukwuemeka Okafor, and Faith Onwuchekwa entitled: “Research and development in Africa: addressing the elephantine problems” notes that the development of the science sector in Africa is fraught with challenges. “Starting with budgetary obstacles. Research and development attracts considerably less public investment in sub-Saharan Africa than defence, education or health. The proportion of GDP devoted to research and development averages about 0.3% on the continent, seven times less than that spent by industrialised countries on this sector”.
Speaking to The Telegraph on condition of anonymity,a former medical health worker noted that Botswana must improve and strengthen policy commitments towards financing for research and development.
“Part of the fight against Covid-19 and other infectious and emerging diseases entails funding research,” he says adding that “Botswana should take a leaf out of South Africa’s book. South Africa invested heavily in HIV/AIDS research and this helped them monitor, evaluate and respond to a wide range of public health issues. Good clinical research can position Botswana at the centre of research efforts into infectious diseases and reducing disease burden.”
United Nations Educational, Scientific and Cultural Organisation (UNESCO) which is a specialised agency of the United Nations (UN) aimed at promoting world peace and security through international cooperation in education and sciences notes that a growing number of African countries have realised that without investment in science and technology, the continent will remain on the side-lines of the global economy.
Over the years, Botswana has shown strong commitment in responding to its HIV epidemic and has become a standard within sub-Saharan Africa. It was the first country in the region to provide universal free antiretroviral treatment (ART) to people living with HIV. The impact of its treatment programme has been extensive. New infections have decreased significantly, from 18,000 in 2005, to 10,000 in 2010, and down to 8,500 in 2018. AIDS-related deaths have also dramatically decreased from a peak of 18,000 recorded in 2002 to 4,800 in 2018.
However, research in the field of HIV and AIDS published between 2014 and 2019 shows that Botswana is not building up a knowledge base in response to this disease. The importance of doing research in Botswana instead of relying on other researchers and institutions is because it helps understand the local social, economic and cultural factors where solutions cannot only be imitated from one country to the next.
Investing in research should not be viewed as channelling money away from treatment and prevention, but simply as a way of levelling the playing field because research is just as important as prevention and treatment. “Health financing is not just about spending more money on health but making sure that the money goes to the right programs,” says the former medical health worker.
The 2020 Gender Protocol Barometre 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.
However, years of under-spending are now creating headaches and the coronavirus pandemic has laid bare the state of Botswana’s public health sector. The pandemic has exposed the serious shortage of critical and lifesaving equipment such as ventilators as well as ICU beds. However, with proper funding and investment in long-term preparedness, these effects can be alleviated.
Global Health Technologies Coalition (GHTC) says “new vaccines, drugs, diagnostics, and other health tools are needed to continue the arc of progress. Health R&D has a multiplier effect. It not only saves and improves lives, but also creates cost savings, drives economic growth, and enhances global security”. The challenge of healthcare financing in Botswana is that it seems to be the biggest challenge in achieving the United Nations Sustainable Development Goal (SDG) No. 3 of “good health and well-being for all.” While the Covid-19 pandemic is not the only crisis Botswana is facing, it will not be the last.
