Duma Care: Why should we care? Evolution of Botswana’s Health Care Reform

On the 19^th November 2024, the President of the Republic of Botswana, His Excellency Advocate Duma Gideon Boko presented the State of the Nations Address (SONA) and stressed under bullet point 48 that his administration will introduce, A National Mandatory Health Insurance Scheme, A Universal Health Coverage Plan for All Citizens, A National Health Digitisation Roadmap to Modernise health system and lastly Investment in Infrastructure. However, in his address of the SONA, His Excellency Adv Boko did not confirm or deny that they already have a blue print manual /roadmap covering the plan. At the time of the presentation HE Advocate Boko did not give any time line on the proposed roll out plan on these initiatives. It was also not stated by His Excellency as to when the Act to effect the “ Duma Care” will be effected. No detailed information was shared by His Excellency on the form UHC and National Health Insurance will undertake. Whether it aims to address pooling and purchasing weaknesses in the health system by internalizing both functions within a single scheme. Is the proposed UHC as per the recommendations of the UNGASS on UHC and National Health Insurance and the WHO One Health Tool? . The scale of the proposals by His Excellency Advocate Duma Boko requires a very long reform path because the achievement of Universal Health Coverage is rarely a single event or a quick undertaker. Furthermore, the path to the delivery of UHC is less clear, which will demand, thorough planning, consultations and resources. However, the “Duma Care” indeed signals positive new strides poised to redirect Botswana’s Health Care System for major reforms and transformation. What lies ahead is a complete game changer juxtaposing the health care reforms to the US Affordable Health Act 2010 (Obama Care) of 2010. Regardless of your political views and convictions, if properly undertaken and administered the “Duma Care“ will be a game changer.