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Botswana at 50 percent population immunity

Vaccine

Despite Botswana’s much celebrated success of COVID-19 vaccination rate against her counterparts, and emerging conversations around herd immunity, the Ministry of Health and Wellness as well as independent experts have warned that it’s still too early to celebrate as Botswana currently sits at 50 percent of herd immunity otherwise known as population immunity.

Herd immunity is an epidemiological concept referring to a situation where enough of a community have acquired immunity to a particular disease to prevent outbreaks. It is usually a combination of those who have been infected by the disease and those who have been vaccinated and usually attained when between 70% and 90% of the population is immune, depending on the transmissibility of the causative organism.

The Ministry spokesperson, Dr Christopher Nyanga in response to this publication said Botswana’s herd immunity is at 50 percent of the entire population. “It means that 50 percent of all Batswana have been vaccinated. It is a he success for an African country since only under 5 or so countries have reached this feat,” he said before warning that this means that the country is still at risk because they have not reached herd immunity.

Although supporting achieving ‘herd immunity’ through vaccination, and not by allowing a disease to spread through any segment of the population, as this would result in unnecessary cases and deaths, the World Health Organization says the percentage of people who need to be immune in order to achieve herd immunity varies with each disease, adding that with COVID 19 not much is known. “For example, herd immunity against measles requires about 95% of a population to be vaccinated.

The remaining 5% will be protected by the fact that measles will not spread among those who are vaccinated. For polio, the threshold is about 80%. The proportion of the population that must be vaccinated against COVID-19 to begin inducing herd immunity is not known. This is an important area of research and will likely vary according to the community, the vaccine, the populations prioritized for vaccination, and other factors,” says WHO.  Herd immunity against COVID-19, they posits, should be achieved by protecting people through vaccination, not by exposing them to the pathogen that causes the disease.

When asked for his views on Botswana’s situation, Public health expert, Dr Edward Maganu said herd immunity means that the percentage of susceptibles is so low that an outbreak cannot occur.  “With Covid-19, the problem is that neither the vaccines nor natural infection give enough immunity to prevent infection in a high level of cases. As a result, made worse by new strains, vaccinated people or those who have had Covid still get infected and transmit infection to others. So outbreaks still occur. In my opinion therefore, taking herd immunity as I described above, we cannot really talk of herd immunity against Covid-19 under the present circumstances,” advised Dr Maganu.

There has been loose talk about herd immunity in the public discourse but experts say it is still early days as many have not taken the vaccine. “Herd immunity would result from a high coverage with a very effective vaccine, or from a large number of people who acquired immunity from natural infection. The infection with the disease has to give very high immunity; for example there are diseases we call immunizing diseases of childhood. Once you get that disease, you become immune for life e.g. measles, mumps, chickenpox etc.

Vaccines against such diseases are also very effective. So, when you have a high percentage (usually above 70%) of your population having been vaccinated or suffered from such a disease, the population acquires herd immunity,” Maganu said. The most recent vaccination report states that as of yesterday (Friday), the number of vaccinated (first dose) people was at 1,419,859 while the number of those fully vaccinated was at 1,157,321.

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Media have a Role in Accelerating Harm Reduction Adoption

8th December 2022

African Scientists and Experts Call for the adoption of a Harm Reduction in approach in Public Health Strategies and Tobacco Control. Media have a critical role to play in accelerating Harm Reduction efforts by informing and sensitizing cigarette smokers on the availability and benefits of alternative, potentially lower risk products to cigarretes. Traditional cessation and smoking prevention norms are not the only ways that smokers who cannot or don’t’ want to quit can make healthier choices that cause less harm to themselves and those around them.

This was said during the 2nd Harm Reduction Exchange conference for African journalists held in Nairobi, Kenya on the 1st of December 2022. Speaking at the Harm Reduction Exchange Conference, Integra Africa Principal Dr. Tendai Mhizha emphasized the role that journalists and media houses should play in handling misinformation and disinformation in tobacco harm reduction discourse that is actually perpetuating the death and disease caused by people continuing to smoke combustible cigarettes. “There has been a lot of disinformation surrounding the topic of nicotine and the alleged negative effects that e-cigarettes have on public health.

This has led to policies that disfavour risk reduces products and narratives that completely deny their benefits. The media have the difficult responsibility to curb the scourge of disinformation and misinformation on harm reduction just like on other socio-political stances that are prescriptive and do not uphold consumers’ right to healthier lifestyle choices,” Dr Mhizha said.

The Harm Reduction Exchange cast a spotlight on alternative ways to reduce harm among tobacco smokers. Held under the theme Harm Reduction: Making a difference in Africa, the conference focused on the progress being made through harm reduction strategies in all fields related to public health such as drug and alcohol abuse, excessive sugar consumption, skin lightening and other addictive and behavioral practices. A wide array of harm reduction strategies and initiatives that are deployed towards reducing unnecessary deaths through non-communicable diseases were presented and discussed.

On his part, Prof. Abdoul Kassé, a world renowned and awarded Oncologist and a Professor of Surgery at the Cancer Institute in Senegal, said that Harm Reduction is a powerful public A Summary of the HR Exchange 30th November  1st December 2022 health tool that has the potential to reduce cancer by 30% and should be at the centre of all public health development strategies. Harm reduction, he said, has already benefited many people in public health and is the most viable alternative in tobacco control.

It applies to areas where there is a need to reduce the harm associated with a practice or consumption of a substance that is overused in society leading to increased morbidity and mortality. “Innovative Harm Reduction initiatives will help to keep more Africans alive. Tobacco Harm Reduction initiatives, including the use of popular e-cigarettes, nicotine patches and chewing gums, have continued to generate a lot of misunderstanding in both the public health community and in the media. However, there is evidence that the use of potentially less harmful alternatives than cigarettes for those who are not willing or cannot give up smoking with currently approved methods may be a solution, not necessarily the best for everyone but by far better than continuous smoking.

Where cessation repeatedly fails, switching to less harmful products is expected to result in benefits for many smokers,” Prof. Abdoul Kassé said. Similarly, views were expressed by Kenya’s Dr. Vivian Manyeki who said tobacco Harm Reduction has a solid scientific and medical basis, and it has a lot of promise as a public health measure to assist millions of smokers. “Many smokers are unable, or at least unwilling, to achieve cessation through complete nicotine and tobacco abstinence. They continue smoking despite the very real and obvious adverse health consequences and against the multiple public health campaigns. Conventional smoking cessation proposals should be complemented with alternative but more realistic options through Harm Reduction,” Dr. Manyeki said.

Tobacco Harm Reduction was introduced to mitigate the damage caused by cigarette smoking—the most dangerous form of tobacco use, and the leading cause of preventable diseases, including cardiovascular disease, lung cancer, and chronic obstructive pulmonary disease. “Nicotine has an addictive potential but plays a minor role in smoking-related morbidity and mortality. Across the world, there is growing interest among experts in novel approaches towards tobacco control and there is an ongoing discussion that reducing the negative effects of smoking can be also achieved by tobacco harm reduction,” Dr. Kgosi Letlape, an ophthalmologist and President of Africa Medical Association and the president of the Association of Medical Councils of Africa, said.

Tobacco cessation is a key factor in the prevention of cardiovascular diseases and cancer. Abstinence from tobacco smoking is one of the primary goals for health promotion and management globally but it is unachievable in a huge amount of cases. This task remains unaccomplished despite extensive public campaigns on the health dangers of tobacco smoking. Thus, the development of novel strategies to reduce smoking is imperative. Moreover, the use of innovations in smoking products has been currently adopted by several smokers to reduce the health risks of smoking.

“The Harm Reduction approach prevents drug-related deaths and overdose fatalities and is the only way out for addicts. In the same way these alternative technologies can reduce tobacco harm and accelerate the journey to a smoke-free world as they reduce exposure to toxicants,” Bernice Apondi, A Policy Manager at Voices of Community Action and Leadership Kenya (VOCAL-Kenya), said.

During the Harm Reduction Exchange, journalists drawn from Southern, West and East African countries, including: Nigeria, Botswana, Ethiopia, Kenya, Lesotho, Malawi, Mozambique, Namibia, Rwanda, Eswatini, Tanzania, Uganda, South Africa, Zambia, and Zimbabwe debated and set forth several resolutions in regards to the present and future as well as the challenges and progress made in Harm Reduction,and science-led regulation.

The Harm Reduction Exchange brought together high-level policy makers, physicians, scientists and health policy experts with media stakeholders from Africa in a lively mix of speeches, presentations, and panel discussions. The key note speakers included Prof Abdoul Aziz Kasse, Ms Bernice Opondi, Joseph Magero, Jonathan Fell, Chimwemwe Ngoma, Clive Bates, Dr. Kgosi Letlape, Dr. Vivian Manyeki and Dr. Tendai Mhizha.

 

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Over 2 000 civil servants interdicted

6th December 2022

Over 2,000 civil servants in the public sector have been interdicted for a variety of reasons, the majority of which are criminal in nature.

According to reports, some officers have been under interdiction for more than two years because such matters are still being investigated. Information reaching WeekendPost shows that local government, particularly councils, has the highest number of suspended officers.

In its annual report, the Directorate on Corruption and Economic Crime (DCEC) revealed that councils lead in corrupt activities throughout the country, and dozens of council employees are being investigated for alleged corrupt activities. It is also reported that disciplined forces, including the Botswana Defence Force (BDF), police, and prisons, and the Directorate of Intelligence and Security (DIS) have suspended a significant number of officers.

The Ministry of Education and Skills Development has also recorded a good number of teachers who have implicated in love relationships with students, while some are accused of impregnating students both in primary and secondary school. Regional education officers have been tasked to investigate such matters and are believed to be far from completion as some students are dragging their feet in assisting the investigations to be completed.

This year, Mmadinare Senior Secondary reportedly had the highest number of pregnancies, especially among form five students who were later forcibly expelled from school. Responding to this publication’s queries, Permanent Secretary to the Office of the President Emma Peloetletse said, “as you might be aware, I am currently addressing public servants across the length and breadth of our beautiful republic. Due to your detailed enquiry, I am not able to respond within your schedule,” she said.

She said some of the issues raised need verification of facts, some are still under investigation while some are still before the courts of law.

Meanwhile, it is close to six months since the Police Commissioner Keabetwe Makgophe, Director General of the Directorate on Corruption and Economic Crime (DCEC) Tymon Katlholo and the Deputy Director of the DIS Tefo Kgothane were suspended from their official duties on various charges.

Efforts to solicit comment from trade unions were futile at the time of going to press.

Some suspended officers who opted for anonymity claimed that they have close to two years while on suspension. One stated that the investigations that led him to be suspended have not been completed.

“It is heartbreaking that at this time the investigations have not been completed,” he told WeekendPost, adding that “when a person is suspended, they get their salary fully without fail until the matter is resolved”.

Makgophe, Katlholo and Kgothane are the three most high-ranking government officials that are under interdiction.

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Masisi to dump Tsogwane?

28th November 2022

Botswana Democratic Party (BDP) and some senior government officials are abuzz with reports that President Mokgweetsi Masisi has requested his Vice President, Slumber Tsogwane not to contest the next general elections in 2024.

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