As tens, possibly hundreds of thousands leave government health facilities without life-saving medication, the Leader of the Opposition, Dithapelo Keorapetse, has made a startling allegation but one that could possibly be true.
“People are dying,” he said in reference to the acute and historic shortage of prescription drugs and other critical medical supplies in government hospitals and clinics. “People are dying of stroke and diabetic coma – which occurs when a patient doesn’t take medication. This amounts to a death sentence and violation of human rights.”
The next point the Selebi Phikwe West MP made invalidates the explanation that the government, through the Ministry of Health, has made ever since the problem began. Through the Central Medical Stores, a unit within the Ministry, Botswana gets its prescription drugs from abroad, mainly India. The explanation that the government has consistently given is that Covid-19 crippled the international drug supply chain that serves it.
“The COVID-19 pandemic has made it difficult for most countries especially in the developing world, to access medical supplies at the rate and quantities that they require,” MoH’s Chief Public Relations Officer Dr. Christopher Nyanga told Sunday Standard a year ago when this problem began. “This is because COVID-19 has slowed down drug production which inevitably affected delivery timelines.”
Nyanga added that as a result, “health facilities in Botswana and elsewhere across the world” had been experiencing shortages and delayed arrival of certain drugs and medical supplies.
Keorapetse challenged this assertion during his speech in parliament.
“The shortage is not a result of Covid,” he said. “Do you want to tell me that we are the only country in the [SADC] region that has been so affected? Why is this not a problem in Mauritius, in Seychelles, in South Africa, in Namibia, in Zambia? Why is there no acute drugs shortage in those countries? Are we the only ones [whose supply chain has been] affected by Covid among so many countries? I don’t think so.”
There is another as relevant question that the MP could have asked: How did it happen that a government swollen with people who took out hefty personal loans from commercial banks to acquire the popular University of Derby MSc in Strategic Management failed to strategically manage a crucial supply chain?
Keorapetse added that what the Opposition Bench has been told and what it believes to be the case, is that “there is interference in the procurement system of the Ministry of Health.” He promised that the Bench will talk more expansively about the latter in the due course.
While there has been no official announcement that the non-adherence to prescription drugs has indeed caused any deaths, there has been official confirmation of such phenomenon by the Ministry itself. On the basis of solid science, health workers at government health facilities routinely tell chronic-disease patients on such drugs that non-adherence to drugs causes a medical condition to worsen and that death could be the result.
Away from the “interference” that he alleged, Keorapetse made a statement of fact regarding why the powers-that-be are never anxious to ensure proper management of the healthcare system. He said that he recently learned that a certain cabinet minister has been hospitalised and that he was absolutely certain that he hadn’t been hospitalised at a government hospital but a private hospital where there is no drugs shortage.
“I don’t think he has been hospitalised at Princess Marina or Selebi Phikwe Hospital or Ramotswa or Nyangabgwe,” the MP quipped.
As Jwaneng-Mabutsane MP Mephato Reatile argued, the problem extends way beyond the shortage because in some cases, even when drugs are available, health professionals who should dispense them are not. He said that he was recently contacted by some constituents of his who complained that they had been waiting for hours on end at a local to fill their ARV prescription. While the drugs were available, the health worker dispensing them was not.
As Sunday Standard reported earlier this year, the shortage problem extends to asthma inhalers and at a period of time that a high-impact respiratory virus is sweeping across the globe. Shortage of inhalers are double jeopardy at a time that a severe acute respiratory syndrome is still running rampant across the globe. Asthma itself is a respiratory condition marked by spasms in the bronchi of the lungs, causing difficulty in breathing. To control this condition, asthma patients need inhalers, which are hand-held, portable devices that deliver medication to the lungs through the mouth. In that regard, asthma is a risk factor for COVID-19.
The explanation from Shirley Mukamambo at the Ministry’s PR office was that the shortage had been occasioned by disruption of the global supply chain since the pandemic began.
“Manufacturing and transportation of the products were delayed; the global demand continues to soar while the supply is shrinking causing scarcity in the markets,” she said. “However, the respiratory solution that is used as a rescue for management of acute episodes of asthma is available in stock.”
That was in January this year but as the medical card of an asthma patient who went to the Letsholathebe Primary Hospital shows on October 27, 2022, Paracetamol pills was all an asthma patient could get. The inhaler he had been prescribed was not in stock.
While President Masisi spoke about this crisis in his speech, he evidently didn’t go far enough. At semantic level, he referred to the crisis as “a matter” and at a substantive level, didn’t portray it as a crisis. In a 65-page, 193-paragraph speech, the president mentioned his Reset Agenda first and nine times and only mentioned the crisis on Page 51 at Paragraph 154.
“The shortage of drugs and other medical supplies in Botswana is of great concern. We are giving this matter our highest attention. As one of the immediate interventions to address the situation, Government has engaged local private entities and pharmacies to help in distributing essential medicines across the country,” he said.