- The Botswana Network on Ethics, Law and HIV/AIDS (BONELA) acknowledges the Ministry of Health’s public admission of the severe medicine and medical supply shortages currently impacting public health facilities. We welcome this transparency, as articulated by the Minister of Health, Hon. Dr. Stephen Modise, during his address to Parliament.
- However, the policy choices outlined particularly the suspension of the Chronic Medicines Dispensing Programme (CMDP) and the halt of referrals for critical non-urgent care raise grave ethical, strategic, and public health concerns.
- The CMDP was instrumental in ensuring continuous access to medication for patients with HIV, TB, diabetes, hypertension, asthma and cancer. Its suspension is likely to result in widespread treatment defaulting, particularly among people living with HIV, Viral rebound and rising drug resistance, increased HIV transmission rates, collapse of continuity of care for thousands of patients.
- Who is providing guidance to the Ministry of Health on these decisions? Have public health experts, development experts, civil society organizations or affected communities been consulted in determining that medication access should be cut first? Sound public health policy should be based on evidence, equity and the ethical principle of do no harm. If these decisions were made without the involvement of diverse and informed stakeholders, they lack both legitimacy and practical grounding.
- The Minister cited over BWP 1 billion in outstanding debts and efforts to mobilize funds from “non-life saving accounts.” Yet we see continued spending on non-emergency priorities, even across other Ministries. In a health emergency, triage must prioritize saving lives, not maintaining non-essential programming.
We call on the Government to:
- Immediately reinstate CMDP and chronic care referrals;
- Reallocate budgets from non-essential capital projects across Ministries to sustain core healthcare;
- Engage civil society and all relevant professionals in a Crisis Health taskforce.
Health is a right, not a privilege. BONELA urges immediate government action to prevent this financial crisis from becoming a full-blown humanitarian disaster.
For more information, contact BONELA on:
Cindy Kelemi at cindyk@bonela.org or 72385054, Katlego Sechele at ksechele@bonela.org or 72282025