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P1 billion cancer project to halt patients’ referrals to SA

Botswana could soon be manufacturing isotopes which would pave the way for cancer treatment in hospitals in Botswana and internationally. The project is the brain child of the Botswana International University of Science and Technology (BIUST) in conjunction with MAGO Enterprise of South Africa.

An isotope is a form of a chemical element whose atomic nucleus contains a specific number of neutrons, in addition to the number of protons that uniquely defines the element. Basically they are atoms of the same element which have different relative masses.
Confirming the development, BIUST Vice Chancellor, Professor Otlogetswe Totolo said “It will be a good example of University-Industry partnership to produce solutions for societies we live in.”  The project will be capital intensive because it will need an injection of close to P1 billion which shall be a cost shared by BIUST and MAGO Enterprise.

But Professor Totolo cautioned that the project is still at its initial stages. He said before the project takes off, they need to have an agreement with the Ministry of Health and Wellness and the Ministry of Tertiary Education, Research Science and Technology (MOTE) because the isotopes will be used in hospitals. Professor Totolo also indicated that the Radiation Protection Agency will also have to regulate the isotopes production facility.

Botswana’s public health facilities predominantly refer cancer patients for treatment and in some cases diagnosis to private facilities. South African hospitals receive a lot of cancer patients from Botswana because of lack of appropriate equipment in Government hospitals. Professor Totolo is confident that having an isotopes production facility will help reduce the number of patients referred to private hospitals especially South Africa for medical attention.

Government currently pays in the region of P92 000 and P200 000 for a single cancer patient referred to a private hospital locally and to South Africa respectively. The main problem at public hospitals is the lack or shortage of equipment used for radiotherapy. The Vice Chancellor said as an institution that is aggressive in research and innovation, their programmes are accredited by Botswana Qualifications Authority (BQA) and various other bodies such as the Engineering Council of South Africa, the Engineers Board and automatically BIUST students are recognized by the Washington Accord because of their affiliation to these bodies. He said technologically advanced projects such as the production of isotopes will position BIUST as an academic centre of excellence while also helping the country to diversify its economy.

Professor Totolo encouraged students to take up sciences and mathematics and enroll in similar subjects with BIUST because they will have the opportunity to provide solutions to the country’s economy by partaking in the in these kinds of projects as they continue to take shape.“I would envisage a BIUST that has more products and services responding to the challenges of Batswana. Botswana is experiencing an increase in the number of cancer cases and a project of this nature will be most welcome in the health sector. A BIUST that has a closer cooperation with other parastatals that have a similar mandate such as BITRI and Botswana Innovation Hub.”  He said the two parastatals could tap into the resources at BIUST to streamline costs and to share knowledge.

Research conducted elsewhere indicates that the rest of the radioisotopes encountered in the world are man-made. When a combination of neutrons and protons, is produced artificially, the atom will usually be unstable and is called a manmade radioactive isotope or radioisotope. Meanwhile studies in developed countries in which surgeons, pathologists, oncologists, radiologists, social workers or psychologists, and nurses are involved in discussing each case suggest that multidisciplinary teams (MDTs) can decrease time to diagnosis, time to treatment, and duplication of investigations, as well as improve accuracy of diagnosis. Thus, the establishment of an MDT is warranted.

According to a journal article that appeared on the Journal of Global Oncology authored by Surbhi Grover, Sebathu Philip Chiyapo, Priya Puri, Mohan Narasimhamurthy, Babe Eunice Gaolebale, and  Neo Tapela: “More than 75% of patients with cervical cancer in Botswana have locally advanced disease. In Botswana, current treatment includes radiotherapy and cisplatin-based chemotherapy. Radiotherapy, however, is not available in the public sector; hence, patients are referred to the private sector for radiation. On the basis of our pilot data, the median time from diagnosis to treatment is 108 days. To decrease cervical cancer morbidity and mortality, it is imperative to identify and address factors contributing to delays,” they wrote.

It is evident from their paper that delays are caused by lack of appropriate equipment and the long waiting list that has to be referred to private hospitals for medical attention. The six health professionals, whose journal is titled Multidisciplinary Gynecologic Oncology Clinic in Botswana: A Model for Multidisciplinary Oncology Care in Low- and Middle-Income Settings indicate that cervical cancer is a major cause of mortality in low- and middle-income countries (LMICs) and the most common cancer diagnosed in women in Botswana. “Most women present with locally advanced disease, requiring chemotherapy and radiation. Care co-ordination requires input from a multidisciplinary team (MDT) to deliver appropriate, timely treatment. However, there are limited published examples of MDT implementation in LMICs.”

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13 AUGUST 2022 Publication

12th August 2022

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DIS blasted for cruelty – UN report

26th July 2022
DIS BOSS: Magosi

Botswana has made improvements on preventing and ending arbitrary deprivation of liberty, but significant challenges remain in further developing and implementing a legal framework, the UN Working Group on Arbitrary Detention said at the end of a visit recently.

Head of the delegation, Elina Steinerte, appreciated the transparency of Botswana for opening her doors to them. Having had full and unimpeded access and visited 19 places of deprivation of liberty and confidentiality interviewing over 100 persons deprived of their liberty.

She mentioned “We commend Botswana for its openness in inviting the Working Group to conduct this visit which is the first visit of the Working Group to the Southern African region in over a decade. This is a further extension of the commitment to uphold international human rights obligations undertaken by Botswana through its ratification of international human rights treaties.”

Another good act Botswana has been praised for is the remission of sentences. Steinerte echoed that the Prisons Act grants remission of one third of the sentence to anyone who has been imprisoned for more than one month unless the person has been sentenced to life imprisonment or detained at the President’s Pleasure or if the remission would result in the discharge of any prisoner before serving a term of imprisonment of one month.

On the other side; The Group received testimonies about the police using excessive force, including beatings, electrocution, and suffocation of suspects to extract confessions. Of which when the suspects raised the matter with the magistrates, medical examinations would be ordered but often not carried out and the consideration of cases would proceed.

“The Group recall that any such treatment may amount to torture and ill-treatment absolutely prohibited in international law and also lead to arbitrary detention. Judicial authorities must ensure that the Government has met its obligation of demonstrating that confessions were given without coercion, including through any direct or indirect physical or undue psychological pressure. Judges should consider inadmissible any statement obtained through torture or ill-treatment and should order prompt and effective investigations into such allegations,” said Steinerte.

One of the group’s main concern was the DIS held suspects for over 48 hours for interviews. Established under the Intelligence and Security Service Act, the Directorate of Intelligence and Security (DIS) has powers to arrest with or without a warrant.

The group said the “DIS usually requests individuals to come in for an interview and has no powers to detain anyone beyond 48 hours; any overnight detention would take place in regular police stations.”

The Group was able to visit the DIS facilities in Sebele and received numerous testimonies from persons who have been taken there for interviewing, making it evident that individuals can be detained in the facility even if the detention does not last more than few hours.

Moreover, while arrest without a warrant is permissible only when there is a reasonable suspicion of a crime being committed, the evidence received indicates that arrests without a warrant are a rule rather than an exception, in contravention to article 9 of the Covenant.

Even short periods of detention constitute deprivation of liberty when a person is not free to leave at will and in all those instances when safeguards against arbitrary detention are violated, also such short periods may amount to arbitrary deprivation of liberty.

The group also learned of instances when persons were taken to DIS for interviewing without being given the possibility to notify their next of kin and that while individuals are allowed to consult their lawyers prior to being interviewed, lawyers are not allowed to be present during the interviews.

The UN Working Group on Arbitrary Detention mentioned they will continue engaging in the constructive dialogue with the Government of Botswana over the following months while they determine their final conclusions in relation to the country visit.

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Stan Chart halts civil servants property loan facility

26th July 2022
Stan-Chart

Standard Chartered Bank Botswana (SCBB) has informed the government that it will not be accepting new loan applications for the Government Employees Motor Vehicle and Residential Property Advance Scheme (GEMVAS and LAMVAS) facility.

This emerges in a correspondence between Acting Permanent Secretary in the Ministry of Finance Boniface Mphetlhe and some government departments. In a letter he wrote recently to government departments informing them of the decision, Mphetlhe indicated that the Ministry received a request from the Bank to consider reviewing GEMVAS and LAMVAS agreement.

He said: “In summary SCBB requested the following; Government should consider reviewing GEMVAS and LAMVAS interest rate from prime plus 0.5% to prime plus 2%.” The Bank indicated that the review should be both for existing GEMVAS and LAMVAS clients and potential customers going forward.

Mphetlhe said the Bank informed the Ministry that the current GEMVAS and LAMVAS interest rate structure results into them making losses, “as the cost of loa disbursements is higher that their end collections.”

He said it also requested that the loan tenure for the residential property loans to be increased from 20 to 25 years and the loan tenure for new motor vehicles loans to be increased from 60 months to 72 months.

Mphetlhe indicated that the Bank’s request has been duly forwarded to the Directorate of Public Service Management for consideration, since GEMVAS and LAMVAS is a Condition of Service Scheme. He saidthe Bank did also inform the Ministry that if the matter is not resolved by the 6th June, 2022, they would cease receipt of new GEMVAS and LAMVAS loan applications.

“A follow up virtual meeting was held to discuss their resolution and SCB did confirm that they will not be accepting any new loans from GEMVAS and LAMVAS. The decision includes top-up advances,” said Mphetlhe. He advised civil servants to consider applying for loans from other banks.

In a letter addressed to the Ministry, SCBB Chief Executive Officer Mpho Masupe informed theministry that, “Reference is made to your letter dated 18th March 2022 wherein the Ministry had indicated that feedback to our proposal on the above subject is being sought.”

In thesame letter dated 10 May 2022, Masupe stated that the Bank was requesting for an update on the Ministry’s engagements with the relevant stakeholder (Directorate of Public Service Management) and provide an indicative timeline for conclusion.

He said the “SCBB informs the Ministry of its intention to cease issuance of new loans to applicants from 6th June 2022 in absence of any feedback on the matter and closure of the discussions between the two parties.”  Previously, Masupe had also had requested the Ministry to consider a review of clause 3 of the agreement which speaks to the interest rate charged on the facilities.

Masupe indicated in the letter dated 21 December 2021 that although all the Banks in the market had signed a similar agreement, subject to amendments that each may have requested. “We would like to suggest that our review be considered individually as opposed to being an industry position as we are cognisant of the requirements of section 25 of the Competition Act of 2018 which discourages fixing of pricing set for consumers,” he said.

He added that,“In this way,clients would still have the opportunity to shop around for more favourable pricing and the other Banks, may if they wish to, similarly, individually approach your office for a review of their pricing to the extent that they deem suitable for their respective organisations.”

Masupe also stated that: “On the issue of our request for the revision of the Interest Rate, we kindly request for an increase from the current rate of prime plus 0.5% to prime plus 2%, with no other increases during the loan period.” The Bank CEO said the rationale for the request to review pricing is due to the current construct of the GEMVAS scheme which is currently structured in a way that is resulting in the Bank making a loss.

“The greater part of the GEMVAS portfolio is the mortgage boo which constitutes 40% of the Bank’s total mortgage portfolio,” said Masupe. He saidthe losses that the Bank is incurring are as a result of the legacy pricing of prime plus 0% as the 1995 agreement which a slight increase in the August 2018 agreement to prime plus 0.5%.

“With this pricing, the GEMVAS portfolio has not been profitable to the Bank, causing distress and impeding its ability to continue to support government employees to buy houses and cars. The portfolio is currently priced at 5.25%,” he said.  Masupe said the performance of both the GEMVAS home loan and auto loan portfolios in terms of profitability have become unsustainable for the Bank.

Healso said, when the agreement was signed in August 2018, the prime lending rate was 6.75% which made the pricing in effect at the time sufficient from a profitable perspective. “It has since dropped by a total 1.5%. The funds that are loaned to customers are sourced at a high rate, which now leaves the Bank with marginal profits on the portfolio before factoring in other operational expenses associated with administration of the scheme and after sales care of the portfolio,” said the CEO.

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