The Botswana Network on Ethics, Law and HIV/AIDs notes with concern growing reports of shortages with regard to essential medicines within health facilities across the districts. These shortages ranges from medications, which provide pain relief such as Paracetamol to medications, which regulate chronic illnesses such as asthma, diabetes and high blood pressure among others. It has also been reported that there are shortages in Methyldopa, being a specific blood pressure medicine used to control elevated blood pressure during pregnancy in particular. Stock outs of this medication have resulted in some women with hypertension giving birth prematurely as alternative medication have proven to be less effective.
Recalling Botswana’s obligations in terms of international and regional law, according to Article 25 of the Universal Declaration of Human Rights (UDHR), everyone has the right to a standard of living adequate for the health and well-being of themselves and their family including food, clothing, housing and medical care among others. This is reiterated at Article 16 (1) of the African Charter on Human and Peoples’ Rights, which speaks to the right of every individual to enjoy the best attainable state of physical and mental health. Under Article 16 (2) of the same instrument, as a State Party, the Government of Botswana is called to take necessary measures to protect the health of their people and to ensure that they receive medical attention when they are sick. Though Botswana has not ratified the International Covenant on Economic, Social and Cultural Rights (ICESCR), Article 12 of the instrument guarantees this same right. In the interpretation of the right to health under General Comment No. 14, the Committee on Economic, Social and Cultural Rights at paragraph 12 (a) provides that ‘functioning public health and health-care facilities, goods and services, as well as programs, have to be available in sufficient quality within the State party.’ According to the same paragraph it is acknowledged that though the ability of a country to provide this, may be affected by their level of development, countries should at least ensure the provision of essential drugs as defined by the World Health Organization (WHO) Action Programme on Essential Drugs. It is note worthy to mention that medicines such as Paracetamol (for acute attack), Telmaisartan (for high blood pressure), Fluticasone (for Asthma) and various Insulins (for Diabetes) all fall within the core list of medications to be in supply as per the WHO.[1] From the various instruments cited, it is therefore evident that the Government has breached its obligation to provide for the adequate supply of essential medications as further supported by key national legislation and policies such the Public Health Act and National Health Policy among others. Along with the severe effects that this breach has on the right to health as well as the right to life, this breach has the effect of worsening the plight of already vulnerable groups such as such as people living with HIV (PLWHIV), women, children and the urban poor. People with disabilities (PWD) who already have challenges accessing health facilities will take on the added burden and expense of traveling from one health facility to another in search of life saving medications.
In light of the above, BONELA calls on the Government of Botswana to urgently rectify and address the shortages in essential medicines across the districts, to protect and promote human health in the country.
Further, BONELA takes this opportunity to further renew its call for the Government of Botswana to include the right to health within the Constitution of Botswana and to ratify and domesticate the ICESCR as a base to strengthen measures to ensure the adequate supply of essential medicines.
[1] WHO Model list of Essential Medicines (2021) available at: https://www.who.int/publications/i/item/WHO-MHP-HPS-EML-2021.02 read together with the Botswana Essential Drug List (2012) available at: https://www.medbox.org/document/botswana-essential-drug-list-bedl#GO .