This will be a three-part series which will deal with how covid 19 has impacted on us as a nation and the corruption laced haphazard response by the regime.
Botswana currently is faced with a crisis—a health, social and economic crisis. As we stated recently, Covid 19 is not just a disease, it is a social, medical and economic menace. Therefore whatever intervention and response by any country should take note of this. As the coronavirus continues its march around the world, governments have turned to public health measures, such as social distancing, to physically disrupt the contagion. Yet, doing so has severed the flow of goods, services and people, stalled economies, and is in the process of delivering the largest global recession in history, with more than two third of the global population currently placed on lockdown. As the virus continues to spread around the globe, we have witnessed the collapse of the global economy and the Market system as we have come to know it.
The free market ideologues continue to refuse to recognise that markets do not on their own work well, as they produce too much of some things-like air pollution and income inequality- and too few of other things like investments in equality education, health and knowledge. Unfettered market system has resulted in creating the Global Medical Industrial Complex which is controlled by Medical Doctors, Pharmaceutical companies and Medical insurance Companies.
In Botswana the system has created a health system which is divided into two components – the public sector and the private sector. Unfortunately, the reality of this divided health system is that only the employed and better off can afford access to many aspects of private health care. Prohibitive costs have made private health care too expensive for most people. High costs have a number of causes, including anti-competitive pricing of medicines, laboratory services and specialist services, collusion among hospital groups and laboratory service providers, and the rising premiums of medical schemes.
This is the consequence of unfettered market system which produces a two-tier health system where the majority of the population relies on poor public health system and the wealthy enjoy premium health facilities finance through medical aid schemes which in a country like Botswana are generally paid through the state.
According to the WHO, we have the following situation in Botswana:
I. Current spending on Health Service as a percentage of GDP is 6%
II. Health Expenditure as a percentage of Total Spending by Government is 14%
III. Total Government Spending accounts for 76% of total spending of Health Service.
IV. Domestic Private Health expenditure as a % of Health Expenditure is 15%
V. Voluntary Health Insurance accounts for 9% of total health expenditure
It is clear from the above that Government accounts for 91% of total spending on health directly and indirectly through parastatals such as University of Botswana, BPC, WUC, etc. However this two-tier system ensures that only those directly employed by Government and parastatals enjoy quality health care system paid for by majority of Batswana through Government revenues. For many Batswana, the term private health care paints a picture of high quality services, personal attention to patients and “state of the art” facilities. In contrast, public health care which caters for majority of Batswana often conveys an image of overcrowded waiting rooms and hospitals, and sub-standard health care services.
Covid 19 has exposed the entire Health Sector in Botswana as a scam to haemorrhage tax payers’ money. Despite all the money spent on the health system by the state the outcomes are extremely poor.
One may also ask about the role of the Private Health Sector in fighting the pandemic. With all the money the state and Batswana spend on these Private Medical Schemes and Private Hospitals, what contribution are they making in this fight. There should be provision of the following:
· Free testing and healthcare at all facilities, including at private hospitals irrespective of whether patients are on medical aid or not.
· Free distribution of essential medical supplies, equipment to public. This should include masks, sanitisers and so on.
· There should be Price control and rationing of essential medical products.
The pathetic response to Covid 19 by the Private Health service providers in this Country shows that, as a Country we need to do away with the current two-tier health system. And given that currently the State already carries 91% of total health expenditure, Botswana needs to establish National Health Insurance Scheme to cater for all Government Employees (including Parastatals) and the rest of Batswana currently reliant on the poor Public health system. Such a scheme should be designed to pool funds which currently constitute 14% of Government Budget to provide access to quality affordable personal health services for all Batswana based on their health needs, irrespective of their socio-economic status. Essential health services and goods should be made available to all people according to their needs, and people should not be disadvantaged by their class, gender or where they live. Botswana needs to address this situation as a matter of urgency.
The insurance scheme will create a unified health system by improving equity in financing, reducing fragmentation in funding pools, and by making health care delivery more affordable and accessible for all Batswana. The scheme will eliminate out-of-pocket payments when the population needs to access health care services. In the long run, households will also benefit from increased disposable income as a result of a significantly lower mandatory prepayment.
WHO defines equity as: “The absence of avoidable or remediable differences among populations or groups defined socially, economically, demographically, or geographically; thus, health inequities involve more than inequality – whether in health determinants or outcomes, or in access to the resources needed to improve and maintain health – but also a failure to avoid or overcome such inequality that infringes human rights norms or is otherwise unfair.”
The covid 19 and state of emergency promotes State sponsored corruption.
March 2020, came with COVID 19 Pandemic which unleased a shocking scale and level of depravity of corruption Batswana have ever witnessed under the BDP. The announcement by the BDP President of a Declaration of a National State of Public Emergency, which we strongly objected to, was followed by authorization of P2.125b (which by the end of 2020 was reported to be P4.2b). The funds were intended to expedite an emergency response, particularly the procurement of what became known as PPE (personal protective equipment) needed to protect frontline health workers and carers from the virus. However, this opening up of funds led instead to an orgy of corruption, which in August was best described by the WHO Director-General Tedros Ghebreyesus as “tantamount to murder”.
A COVID-19 Relief Fund was created and credited with P2.125 billion to support the interventions. To sustain economic activity and livelihoods, an economic relief package was implemented in April 2020, which included:
Wage subsidies for 3 months for employees in businesses adversely affected by COVID-19;
Provision for deferment of profits taxes payable by businesses;
Waiver of certain levies due to Government;
As stated above, in August 2020, the Ministry of Finance Officials reported that the Covid Budget was P2.1b however two months later on 09/11/2020 President Masisi reported to Parliament that the Government had already spent P4.2b on Covid-19. This was part of the grand scheme to loot under the State of Public Emergency. Batswana have witnessed in the past 16 months of the Covid-19 pandemic how the BDP regime used the State of Public Emergency and the procurement policies and laws to create opportunity for corrupt people, including government officials, to steal from the state’s purse.
An obvious consequence of this is that the looting hinders the implementation of essential programmes designed to eradicate poverty. In an emergency situation like the current pandemic, this could become a matter of life and death. The media is brimming with headlines on public servants and representatives alike disregarding these policies. Many headlines point to the looting of funds meant for the provision of vital, life-saving personal protection equipment (PPE) such as sanitisers, surgical gloves and masks.
Investigating the covid 19 corruption
THE UDC demands a complete and independent Audit on how COVIDS FUNDS WERE SPENT: In particular we need to focus on the following:
1. Over-pricing of Personal Protective Equipment (PPE);
2. Possible recoveries relating to under-delivery by service providers;
3. Identify Service providers were awarded contracts hilst not being registered for VAT;
4. PPE price differentiation was beyond market-related prices;
5. Service providers charged rates for the supply of PPEs in excess of the prices existing before the pandemic
6. Identify Companies who were found to have only been registered with the CIPA during February and March 2020;
7. Identify Non-essential goods which were procured under the Covid-19 emergency provisions;
On food parcels, the investigators must establish how much was spent on each of the 57 Constituencies and which companies supplied the food parcels. In that way MPs and Councillors for each Constituency will be able to trace how much was spent and who were the beneficiaries. Despite the fact that the Minster of Local Government stated that the Government spent over P600m on food parcels, majority of families never received any food and for those who were lucky the distribution was only made for one month. Government should account for all COVID 19 funds by simply give the following breakdown.
BOTSWANA’S VACCINE ACQUISITION PLAN
We continue to witness the dysfunctional nature of this corrupt regime on vaccine acquisition. According to the Statement of the 30/07/2021 by Dr Dikoloti, “the Government has thus far, identified different platforms for the procurement of vaccines. Furthermore, payments of US$19,234,882 million or around P210,000,000 have already been made, in order to secure the various vaccines”. This was payment for the following vaccines:
VACCINES. QUANTITIES
COVAX Vaccines. 940,800
AVATT-Johnson & Johnson. 1,152,654
Sinovac. 200,200
Covaxin. 100,000
Moderna. 500,000
Pfizer. 2,000,000
Plus donated vaccines Covaxin 30,000
Sinovav. 261,900
Pfizer 81,900
TOTAL VACCINES
5,266,554
These numbers do not make sense at all. Why will this regime order 5.3 million vaccines to vaccinate 1.6m Adult population in Botswana especially that J &J is a single shot vaccine. Clearly this regime is giving these inflated numbers in order to facilitate stealing from fiscus.
As if what Dikoloti presented was not outrageous enough, hardly two weeks later, on the 13/08/2021, the head of the regime, President Masisi in his national address stated that in fact the total amount spent on procurement for the same amount of Vaccines is P390m, an additional P180m to what the Minister had reported. This regime is shamelessly corrupt. The level of corruption and impunity on the part of this regime drives us further down the road of unemployment and poverty. In the driver’s seat is President Masisi, whose government is the most authoritarian, callous and inept of all. And now when our population is screaming in pain over crime, poverty, high food prices, crises in the health sector through lack of medicines and other services and the collapse of the education system, unmaintained public infrastructure and the loss of business competitiveness, this regime does nothing to ease the pain and instead promotes looting through the State of Public Emergency. This government has become numb to the needs of the people. The nation expects to be protected and cushioned from the social and economic hardships visited on it as a result of the pandemic. The head of the regime should have announced measures that they will put in place to support families of workers who have lost jobs due to this pandemic. He said nothing about businesses that are most affected. As if late acquisition of vaccines and failure to save lives was not enough pain on the nation, the government is not even able to show compassion and care to the struggling survivors. We are on our own.
