Botswana completes WHO Intra vaccine action review
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After bearing heavy criticism for an ill-advised COVID-19 vaccine rollout and COVID-19 response, Botswana seems to have bounced back in the game, according to a newly released report from the World Health Organisation (WHO).
A report released on 19th August 2021 from WHO reads: “with WHO support, Botswana is one of four African countries that have completed an intra action review of their early COVID-19 vaccine rollout to help shape the next phase.”
The report quotes the Director of Health Services at Botswana’s Ministry of Health and Wellness, Dr. Malebogo Kebabonye saying: “The aim was to spot challenges and best practices, so we can keep customizing our rollout. It helped us take quick corrective measures and improve our services.”
In recent days the country has been battling negative publicity following incidences that the country was undergoing an unprecedented crisis of failure to plan. According to the report, the country conducted surveys to gauge public perceptions around vaccinations and set up a national ‘ArmReady’ information campaign to prepare the public.
“Our national deployment plan was sanctioned at the level of the Cabinet Office. The surveys showed 76% acceptance of the vaccination among the public. Through the ‘ArmReady’ campaign, we also sought to pre-empt small pockets of resistance,” says Dr. Kebabonye.
“Our first phase, aiming to reach 264 000, is about protecting the health system. The second is to ensure continued economic activity. The final phase will target 18-29-year-olds,” she said. “Multi-sectoral involvement and coordination from the Presidential Task Force and the Ministry of Health were key. We appointed liaison offices at the national and sub-national levels and used community centres as vaccination sites. This helped communities to take ownership,” Dr. Kebabonye explains.
Kebabonye revealed that they piloted their rollout at several sites first and then grew them out based on their capacity. Given the supply issues, this snowballing approach has been convenient, she added.
Covering all bases
According to the report, Botswana planned for a range of scenarios and challenges before the rollout began, including uncertainty around the supply of vaccines. WHO applauded Botswana: “We’re urging African countries to plan for multiple scenarios, just like Botswana did,” says Chanda Chikwanda, who leads WHO Africa’s Vaccines Learning Agenda, which helps share lessons between African countries to strengthen the rollout of vaccines.
“We need to be flexible, depending on how the vaccine responses are going and on whether vaccines arrive on time. There are so many possible scenarios, so flexibility is imperative.”
The statement says that suitable financing, including resource mobilization and constant monitoring and evaluation tools based on sound data collection, strengthened Botswana’s early rollout.
“Countries that emphasize resource mobilization have shown themselves to be best placed to do well. Eswatini secured enough funds to vaccinate its entire population, and Rwanda, Angola, and Ghana all invested in cold chain capacities early,” says Chikwanda. “We must also get to the hard-to-reach groups, including mobile populations and people living in remote areas. Lesotho used the flying doctors to reach remote communities,” she added.
Public and Health workers’ response
On the challenges faced, Dr. Kebabonye revealed to WHO that “the squeeze on supplies of vaccines has also served to push up public distrust in Botswana’s vaccine rollout.” According to Ministry, “a level of vaccine hesitancy was also found among some younger health workers, which was compounded by the spread of misinformation on and offline.”
Like many countries, Botswana has faced challenges in ensuring enough vaccinators, nurses and health professionals, and support staff is on hand. Equipment shortages and low internet bandwidth in some areas have hampered the use of the electronic data systems that track the administration of vaccines and adverse effects.
“We’ve expanded the knowledge we share with our healthcare workers and communities around [any potential] adverse effects, including on assessing and managing side effects,” says Dr. Kebabonye. When asked for advice for other African countries, Dr. Kebabonye cites an incremental and agile approach, with a strong emphasis on consistent testing and learning.
“These reviews, like the one we ran in April with WHO, need to be continuous processes that all countries do to keep on improving,” said Dr. Kebabonye. Nine more African countries recently expressed interest in conducting similar reviews, WHO said.
“We’re learning as we go to some extent with this new virus and unprecedented vaccination drive,” said Dr. Phionah Atuhebwe, New Vaccines Introduction Officer with the World Health Organization’s (WHO) Africa Regional Office. “It is crucial that we keep a close, sharp eye on progress and that we share lessons between countries. This way, we all improve our COVID-19 vaccine rollout together.”
Meanwhile, the report further said that Africa’s largest-ever vaccination drive is well underway.52 African countries are rolling out COVID-19 vaccines, and over 73 million doses have been administered on the continent.
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ENVIRONMENT ISSUES: Masisi asks Virginia for help
President Mokgweetsi Masisi says the issue of sustainable natural resources management has always been an important part of Botswana’s national development agenda.
Masisi was speaking this week on the occasion of a public lecture at Virginia Polytechnic, under theme, “Merging Conservation, Democracy and Sustainable Development in Botswana.”
Botswana, according to Masisi, holds the view that the environment is fragile and as such, must be managed and given the utmost protection to enable the achievement of Sustainable Development Goals (SDGs).
“It is necessary that we engage one another in the interchange of ideas, perspectives, visualizations of social futures, and considerations of possible strategies and courses of action for sustainable development,” said Masisi.
On the other hand, dialogue, in the form of rigorous democratic discourse among stakeholders presents another basis for reconfiguring how people act on their environments, with a view to conserving its resources that “we require to meet our socio-economic development needs on a sustainable basis,” Masisi told attendees at the public lecture.
He said government has a keen interest in understanding the epidemiology and ecology of diseases of both domestic and wild animals. “It is our national interest to forestall the dire consequences of animal diseases on our communities livelihoods.”
President Masisi hoped that both Botswana and Virginia could help each other in curbing contagious diseases of wildlife.
“We believe that Virginia Tech can reasonably share their experiences, research insights and advances in veterinary sciences and medicines, to help us build capacity for knowledge creation and improve efforts of managing and containing contagious diseases of wildlife. The ground is fertile for entering into such a mutually beneficial partnership.”
When explaining environmental issues further, Masisi said efforts of conservation and sustainable development might at times be hampered by the emergence and recurrence of diseases when pathogens mutate and take host of more than one species.
“Water pollution also kills aquatic life, such as fish, which is one of humanity’s much deserved sources of food. In this regard, One Health Approach imposes ecological responsibility upon all of us to care for the environment and the bio-diversity therein.”
He said the production and use of animal vaccines is an important space and tool for conservation, particularly to deal with trans-border animal diseases.
“In Botswana, our 43-year-old national premier pharmaceutical institution called Botswana Vaccine Institute has played its role well. Through its successful production of highly efficacious Foot and Mouth vaccines, the country is able to contain this disease as well as supply vaccines to other countries in the sub-region.:
He has however declared that there is need for more help, saying “We need more capacitation to deal with and contain other types of microbial that affect both animals and human health.”
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Masisi saddened by deaths of elephant attacks
President Mokgweetsi Masisi has expressed a strong worry over elephants killing people in Botswana. When speaking in Virginia this week, Masisi said it is unfortunate that Batswana have paid a price with their own blood through being attacked by elephants.
“Communities also suffer unimaginable economic losses yearly when their crops are eaten by the elephants. In spite of such incidents of human-elephant conflict, our people embrace living together with the animals. They fully understand wildlife conservation and its economic benefits in tourism.”
In 2018, Nthobogang Samokwase’s father was attacked by an elephant when travelling from the fields, where he stayed during the cropping season.
It was reported that the man couldn’t run because of his age. He was found trampled by the elephant and was pronounced dead upon arrival at the hospital.
In the same year, in Maun, a 57-year-old British woman was attacked by an elephant at Boro and died upon arrival at the hospital. The woman was with her Motswana partner, and were walking dogs in the evening.
Last month, a Durban woman named Carly Marshall survived an elephant attack while on holiday in the bush in Botswana. She was stabbed by one of the elephant’s tucks through the chest and was left with bruises. Marshall also suffered several fractured ribs from the ordeal.
President Masisi Botswana has the largest population of African elephants in the world, totaling more than 130 000. “This has been possible due to progressive conservation policies, partnerships with the communities, and investment in wildlife management programmes.”
In order to benefit further from wildlife, Masisi indicated that government has re-introduced controlled hunting in 2019 after a four-year pause. “The re-introduction of hunting was done in an open, transparent and democratic way, giving the communities an opportunity to air their views. The funds from the sale of hunting quota goes towards community development and elephant conservation.”
He stressed that for conservation to succeed, the local people must be involved and derive benefits from the natural resources within their localities.
“There must be open and transparent consultations which involve all sectors of the society. It is against this backdrop that as a country, we lead the continent on merging conservation, democracy and sustainable development.”
Masisi stated that Botswana is open to collaborative opportunities, “particularly with identifiable partners such as Virginia Tech, in other essential areas such as conservation, and the study of the interplay among the ecology of diseases of wild animals and plants, and their effects on human health and socio-economic development.”
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Gov’t commit to injecting more funds in fighting HIV
Minister for State President Kabo Morwaeng says government will continue to make resources available in terms of financial allocations and human capital to ensure that Botswana achieves the ideal of eradicating HIV and AIDS as a public health threat by 2030.
Morwaeng was speaking this morning in Gaborone at the High-Level Advocacy event to accelerate HIV Prevention in Botswana. He said the National AIDS and Health Promotion Agency (NAPHA), in partnership with UNAIDS, UN agencies, the Global Fund and PEPFAR, have started a process of developing transition readiness plan for sustainability of HIV prevention and treatment programmes.
“It is important for us, as a country that has had a fair share of donor support in the response to an epidemic such as HIV and AIDS, to look beyond the period when the level of assistance would have reduced, or ceased, thus calling for domestic financing for all areas which were on donor support.”
Morwaeng said this is important as the such a plan will guarantee that all the gains accrued from the response with donor support will be sustained until the end when “we reach the elimination of HIV and AIDS as a public health threat by 20230,” he said.
“I commit to continue support efforts towards strengthened HIV prevention, accentuating HIV primary prevention and treatment as prevention towards Zero New Infections, Zero Stigma, Discrimination and Zero AIDS related death, to end AIDS in Botswana.”
He reiterated that government commits to tackle legislative, policy and programming challenges that act as barriers to the achievement of the goal of ending AIDS as a public health threat.
In the financial year 2022/2023, a total of 119 Civil Society Organizations, including Faith Based Organizations, were contracted with an amount of P100 million to implement HIV and NCDs prevention activities throughout the country, and the money was drawn from the Consolidated Fund.
Through an upcoming HIV Prevention Symposium, technical stakeholders will use outcomes to develop the Botswana HIV Prevention Acceleration Road Map for 2023-2025.
Morwaeng stated that government will support and ensure that Botswana plays its part achieving the road map. He said there is need to put hands on the deck to ensure that Botswana sustains progress made so far in the fight against HIV and AIDS.
“There are tremendous achievements thus far to, reach and surpass the UNAIDS fast track targets of 95%- 95%- 95% by the year 2025. As reflected by the BAIS preliminary results of 2021, we now stand at 95- 98- 98 against the set targets.”
“These achievements challenge us to now shift our gears and strive to know who are the remaining 5% for those aware of their HIV status, 2% of enrolment on treatment by those aware of their status and 2% of viral suppression by those on treatment.”
Explaining this further, Morwaeng said shift in gears should extend to coming up with robust strategies of determining where these remaining people are as well as how they will be reached with the necessary services.
“These are just some of the many variables that are required to ensure that as a country, we are well positioned to reaching the last mile of our country’s response to the HIV and AIDS pandemic.”