Monday the 27th Parliament will resume its July meeting. What is specifically on the agenda of Parliament in this coming meeting? A lot! There will be government and Private Bills, policy proposals, questions, themes and motions.
The meeting is also likely to be punctuated by statements from ministers on a variety of issues. Some statements may come as preemptive strikes to prevent the opposition from either making speeches on the subjects ahead of the government or to simply forestall questions on same. The House is expected to be active for five weeks nonstop. It is obviously a very short time considering the agenda.
Before its adjournment sine die in March, Parliament was supposed to discuss the National Development Plan 11 Midterm Review. This is what will become a priority of the government in its order of Business or scheduling. The government is expected to table an addendum to the already tabled review document.
The reason is simple, COVID-19 has not only gobbled funds from the fiscus, but has also resulted in a sharp decline in government revenue. The mainstay of the economy is mining, particularly diamonds revenue. These germs are mainly luxury commodities which are prone to international market changes.
Diamonds and other precious goods are seldom needed in large quantities during turbulent times such as these. Those countries that depend on them, such as Botswana, are always at high risk of external shocks. Southern African Customs Union revenue is also likely to decline because of slump in trade.
Tax collection has gone down due to many obvious reasons. Tourism has been shattered. Non-mining sector has also been negatively affected. Therefore, the estimated revenue has declined, necessitating a serious review of the development plan.
Which Bills are likely to be debated in this coming meeting? Two Botswana Defence Force Amendment Bills have been Gazetted; one is Private and the other a government proposal.
The private Bill is proposing to rectify the injustice of not fully paying soldiers who are on indictments or suspensions. The government Bill is a minor amendment relating to the BDF Court Marshall Judge Advocate General position.
Other government Bills include Income Tax Amendment, BURS Amendment, Citizenship Amendment, Legal Practitioners Bill, Environment Assessment Amendment, Financial Reporting Amendment, Accountants Amendment, Citizen Economic Empowerment Bill and a controversial one on Floor Crossing.
More interest will be on the anti-defection Bill and perhaps the citizen economic empowerment proposal. Other Private Bills to be tabled include Police and Prisons Amendment and the Media Practitioners Repeal Bill. Parliament will also debate the following policies; Climate Change, Tourism, National Energy and Minerals.
Whilst there is nothing on COVID-19, MPs are likely to ask questions on the pandemic. So many things come to mind as possibilities of issues likely to be raised. MPs are likely to ask the Ministry of Health, Office of the President and the Ministry of Finance and Economic Development about the whole pandemic fighting strategy.
There may be questions on the capacity and reliability of COVID-19 testing. Questions may be asked on positive cases that quickly become negative and or false alarms cases etcetera.
More focus may be on the budget and procurement. Some controversial tenders are likely to be questioned by MPs. It is expected that given the chance, MPs will likely lament the stoppage of food rations distribution by the Ministry of Local Government and Rural Development.
MPs will raise other miscellaneous issues on corona virus related policy decisions. These include the terms of engagement of the COVID Task Force and enlisting of the public relations private persons team from outside the government to help.
There may be questions by MPs on the business dealings of the President and his intention to acquire a government ranch, Banyana Farm. Clarity may be vehemently sought on these issues. Corruption related issues may be on the agenda of Private Business. So many issues have been reported; direct appointment of the 100KM NSC water pipe tender and other controversies may crop up.
There may be clarification required from the ministry responsible for international relations on the implications of the engagement of an Advocate working for Afri-Forum white supremacist organisation. The consequent and seeming tension between South Africa and Botswana will probably be on the agenda of MPs.
Recently the country has experienced serious fuel shortages. It is likely that parliament will raise issues on this matter and get the Minister to explain further.
Whilst this issue has been all over the media with clarifications offered by the Minister and the Permanent Secretary, parliament is likely to engage on the matter to get assurances into the record.
Answers will be demanded on the exact cause of the shortage, policy failures to predict the crisis and to avert it as well as the way forward.
Power issues have also irked MPs, particularly the recent tariff increases and recent threats to increase them even. All is definitely not well at Botswana Power Corporation, so MPs are probably going to probe these matters further. It is clear that there is a lot that Parliament will deal with.
The disheartening fact to note is that most of the Government Business will be expected, by the executive, to pass through parliament rather than be passed by it. There is condescension for free and adequate debate as well as ostensible intolerance of alternative views from the backbench and the opposition by the frontbench.
The ruling party caucus will discuss all these matters and once explained fully by technocrats, the expectation will be for MPs to swiftly rubberstamp executive ideas without raising controversial issues or simply reasoning on the floor.
There will be no time to reason! There is likely to be limited time allocation, in terms of minutes allocated to individual MPs per debate, on all these matters aforementioned. The Speakership, which traditionally is the gatekeeper of the executive, is likely to fully cooperate and not protect the MPs against the executive wrath.
The executive will reason that five weeks is too short and that all business must be dispensed with before time elapses. Whilst the backbench will be unhappy with these decisions, there’s nothing it will do, it is numerically weak in the caucus.
The opposition will face the whole ruling party bench and be defeated in their protest for adequate debate time. That’s just how things work in Botswana parliament. The legislature is a governing tool of the executive; it is used to pass through policies, laws and budgets for the ruling party’s own political ends.
It is not an independent institution which can hold the executive accountable effectively. If Bills or policies are not completed and there’s about week remaining, everything could be squeezed into that one last week. It has happened before; the House can pass many Bills in one sitting, even if it means staying up until late night or wee hours of the morning.
There are private motions which if not withdrawn and replaced with new ones, may not address topical issues that arose as a result of or during COVID-19. These are motions which may seek accountability of the government on corona virus related policies.
One of the likely motions is the motion touted by one of the opposition parties; motion of no confidence on the government. If this motion comes on urgency, it may die on arrival.
The ruling party MPs will be under strict instructions to kill it the moment a question is put on whether the agenda should be changed to allow a debate on it.
The only way it can be debated is if it comes in through the normal process. Even that way there is no guarantee; the ruling party MPs may stay outside to kill the quorum like they do with motions they don’t want debated.
They may also debate it and unleash their ‘attack dogs’ and put their views across before defeating it. Other motions which may be tabled include COVID-19 related motions. Expectations of the general public should be managed; the next meeting may be the usual ruling party show to do as they please.
The great Thomas Edison, who logged a total of 1093 patents singly or jointly in his 84-year lifespan and who was the driving force behind a whole host of innovations which included the incandescent light bulb, once said, “I’d put my money on the sun and solar energy.
What a source of power! I hope we don’t have to wait until oil and coal run out before we tackle that.” At the onset of the still-in-force NDP 11, which runs from April 2017 to March 2023, government hived off P2.25 billion (a move engendered by the irregular, if not corrupt, depletion of the National Petroleum Fund) from the BPC subsidy budget pertaining to that time horizon and re-oriented it toward the development of the bulk petroleum product storage terminal at Tshele Hills near Rasesa village in Kgatleng District.
Both the two contenders for the Egyptian throne, General Atiku, had made their case and it was now up to the Wise Men to pass a vote indicating whose deposition had convinced them.
To Ramesses’ surprise, General, the Wise Men all voted for Moses. The vote was indicated by bowing their knees in front of Moses, thus confirming that he had a superior claim to the throne. Sadly, Ramesses was not having any of that. He immediately put his army on the alert and when word seeped through that Moses was to be the new Pharaoh, Zaru erupted into jubilation on the streets.
The Human Immunodeficiency Virus (HIV) was first detected in Botswana in 1985. The coronavirus that causes Covid-19 was detected in 2020. Both viruses were new, and it was their global occurrence that led to their classification as pandemics.
They have both been traced to animals, something not surprising as most new viruses are actually cross-overs from animals. A virus crosses species, in this case to humans, and its subsequent behaviour depends on how it adapts to the new species. Many are “dead-ends”, the virus cannot multiply or be transmitted between members of the new species.
In the case of the two which are our subject in this paper, the viruses adapted to the new species (human) and underwent mutations that allowed them to be easily transmitted between humans, hence the rapid spread.
The two viruses, HIV and the Covid-19 virus are very different, hence their mode of spread is different and their mechanisms of disease causation and epidemiology are very different. The approach to their control is of necessity very different. To illustrate their difference, HIV is transmitted mainly by sexual intercourse, Covid-19 virus mainly by the droplet method through the respiratory tract.
HIV causes ill health a long time after infection, which can run from about two years to many years (incubation period); the incubation period of Covid-19 is a few days, estimated at between 10 and 14 days. HIV infection leads to the destruction of the immune system, and when the victim gets ill, it can be from any of a wide variety of diseases caused by “opportunistic infections or even cancers”, hence the name Acquired Human Immunodeficiency Syndrome (AIDS).
Covid-19 on the other hand presents generally as an upper respiratory tract infection (URTI) although there are some presenting differently, especially with lower respiratory infection (lungs affected) in the more severe cases. Another but very important difference is that, while Covid-19 is generally an acute, self-limiting illness, with most patients recovering fully within a few weeks, and in fact many showing no symptoms, HIV/AIDS is a chronic condition; once the patient starts signs and symptoms, usually years after infection, this leads invariably to death from one of the opportunistic infections or diseases.
This last scenario used to be the case in the first decades of HIV/AIDS, but has fortunately changed after the development of drugs that in combination are referred to as Highly Active Anti-Retroviral Therapy (HAART, now known as ART).
HIV/AIDS is now treatable and no longer a death sentence, although treatment lasts for life as the drugs do not eliminate the virus from the body but suppress it. As for Covid-19, there is currently, as is the case generally with viral infections, no effective antibiotic or antiviral drug that kills the virus or eliminates it from the body.
Where does this put us? We are essentially dealing with two diseases or pandemics that are very different from each other. I did my post-graduate studies in Public Health during the last years of smallpox eradication, actually I finished the studies in 1978, the year Smallpox eradication was certified in Botswana.
What used to be emphasized, why the world succeeded in eradicating Smallpox was that it had epidemiological characteristics that supported eradication: it was easy to diagnose, even by lay people; it had a consistent incubation period of about 10 days; it virtually had a 100% manifestation rate (everybody infected showed typical signs and symptoms); there was a vaccine against it that was virtually 100% effective. Unfortunately, there have been few diseases with such favourable characteristics for eradication. Hence the next disease targeted for eradication, Polio, is almost done but still causing some problems.
Response to the HIV/AIDS and Covid-19 pandemics in Botswana
When HIV was detected in Botswana in 1985, the world had been aware of the existence of AIDS for about five years, that is, since the outbreaks among gays in America in 1981. By 1985 the virus had been identified but little was known about it; it was still a subject of intense research. However we knew that it caused AIDS and was no longer just transmitted in gay sex, but that most transmission in Africa was through heterosexual sex, and that sexual transmission was responsible for more than 90% of transmission occurring in Africa.
Some African countries were already experiencing severe HIV/AIDS epidemics, especially in Central and East Africa. In some of them (Uganda is sometimes quoted) people started dying in large numbers before the cause was known, only for people to move to neighbouring villages and infect others there!
The Botswana HIV epidemic, as well as those of SACU countries generally, was later than those of Central and East Africa. The latter had already experienced high disease and mortality rates for some years. In the late 1980s, Botswana was experiencing a big economic boom, and this attracted professionals, technicians and artisans from African countries badly affected by HIV/AIDS, and this really speeded up transmission in the country.
When the first seropositive people were identified in 1985, I was Assistant Director of Health Services responsible for Primary Health Care. So, Disease Control fell in my Department, and I had the responsibility of reporting to my seniors at the Ministry and hence to the country that we now had HIV.
Control measures were started immediately, such as screening all blood donated for transfusion and putting together with the help of WHO, the first short-term control plan. A unit was created which was headed by an appropriate professional. In 1986 I became Director of Health Services and Deputy Permanent Secretary, and in January 1990 I became Permanent Secretary.
In all these positions I was intimately involved in HIV/AIDS control, working intimately with those directly responsible for the unit/programme, and also doing at least one assignment with Global Programme on AIDS (GPA) when it was still with WHO before UNAIDS was created to share the AIDS programme with other UN Agencies. In the same manner, here at home we started pushing for the multisectoral approach to HIV/AIDS control in the early 1990s, that resulted in the formation of the National AIDS Council and eventually NACA.
The Ministry of Health undertook a very intensive public education from early in the HIV epidemic. The Ministry warned the people of Botswana (through and including the political, traditional and community leaders) about what was going to happen, the impending doom of high morbidity and mortality. What was needed was change is sexual behaviour.
Everyone knows that the main message from the Ministry was “ABC” (abstain, be faithful, condomise), which had become a universal message especially in Africa was used by the Ministry. Put in other words, the message aimed at three things; i) delaying sexual debut, ii) avoiding multiple concurrent partners and iii) consistent condom use.
This message never made an impact on the Botswana population, so when the clinical cases started hitting the country after the several years of silent spread (the silent phase of HIV spread), the effect was disaster. We had a nasty surprise in the health system that while the countries in central Africa that had early HIV/AIDS epidemics had their HIV prevalence plateauing at 15% and we thought the same would happen here, in Botswana and Southern Africa prevalence rates went past 30%.
This was due partly to the sexual practices of our people but also to the HIV sub-type that was prevalent in our part of the world. By 1966 Botswana was declared as having the highest prevalence of HIV in the world.
The real heavy load of cases in Botswana started in the mid-1990s, and everybody remembers it; funerals and funerals and funerals. That time ARVs were still under development, and it was only at the end of the 1990s that they became available but very expensive, so most poor and middle income countries could not immediately afford them.
Thanks to India, Thailand and Brazil who broke the patents and manufactured the drugs, their availability to many developing countries would have taken a long time. Here in Botswana, it was due to the initiative of the then President that HAART became available for general use in Government facilities in 2002, with massive aid from PEPFAR and ACHAP (supplied by Merck Foundation and the Bill and Gates Foundation).
Otherwise there was talk of extinction, and the expected population pyramid produced by UNAIDS was frightening. Luckily because of ARV’s that scenario did not occur. The rest of Botswana’s HIV/AIDS trajectory up to now is history. I left Government service on 31st December 1996 after seven years as P.S. and joined WHO.
I had almost joined WHO in 1989 but deferred it when I was appointed PS and did not want to appear unpatriotic and disappoint President Masire and PSP Legwaila with both of whom I had very excellent relations. My initial job with WHO was in Tuberculosis, a disease that had been my passion since I did Public Health and took over its control as head of disease control in 1979.
No matter what post I held in the Ministry thereafter, I participated directly in Tuberculosis control. And as we all know. Tuberculosis became and is still one of the manifestations of HIV globally and in Botswana.
HIV/AIDS was and is a slow epidemic. So, the public did not really perceive it as a threat in Botswana, except perhaps in the late 1990s and early 2000s when it caused very high mortality in the country. The Covid-19 epidemic/pandemic is different. Although it doesn’t kill everybody who gets it like HIV-related disease did, we have seen in highly affected countries that the 2-5% it kills translate to large numbers, because this is an acute infection that spreads very quickly. So, it should be easy for the public to perceive its danger.
The surveillance and containment that has been employed so far in Botswana to control the spread of Covid-19 has been very effective. Those responsible, the Ministry of Health and Wellness and the Task Force deserve to be acknowledged and thanked for a job well done. I am confident that the health care system can also adjust itself and not be disrupted by this new threat.
Since the chances of developing a drug against such a virus seems a bit remote, we are all putting our hope on a vaccine. Many viral diseases have very effective vaccines, so this keeps our hope up. We also need to know if one attack of this disease results in life-long immunity (like measles, mumps, chicken pox etc.) or if one can be attacked more than once, implying that the virus keeps mutating and bringing up new sub-types.
We are still to see if the public will do better than they did with HIV/AIDS and follow the health education. Experience is what usually persuades people to change; that is why many believe the celebrated change in Uganda when people changed and HIV infections dropped was due to the large mortality they had experienced before they even knew what was killing them.
Regarding Covid-19, we are seeing in a number of badly affected countries, people ignoring or resisting social distancing measures and masks, sometimes encouraged by politicians! Here in Botswana we have not yet experienced large losses of lives from Covid-19, so it is still to be seen how the public will really conform to advice, especially on social distancing and other measures like masks and hand washing.
What one sees so far is not very encouraging -in combis, bars etc., and during weekends in homes. In health we talk of KAP (Knowledge, Attitude, Practice). We know that K does not always lead to change in A, and to P. We saw this plainly in HIV/AIDS, what is going to happen in Covid-19?