Botswana rarely challenged on ARV supply - Dikoloti
Despite the relatively high demand for Antiretrovials (ARVS), Botswana’s supply chains rarely experience challenges in maintaining availability. This was said by the Minister of Health (MoH), Dr Edwin Dikoloti at the launch of the Botswana National Supply Chain Strategy in Gaborone this week.
Dikoloti credited their robust quantification and inventory management of ARVs that they rarely experienced challenges in maintaining the supply. He added that it was their intention to leverage lessons learnt with ARVs to improve supply chain management for other essential medicines such as those for non-communicable diseases.
“We pride ourselves on being amongst the few nations that have attained the UNAIDS 95-98-98 targets, significantly reduced mother-to-child transmission of HIV and achieved high immunisation rates for vaccine-preventable disease. As we celebrate these milestones, let us not forget to also pay tribute to the team of dedicated supply chain experts who, daily, ensure that the right medicines and related health commodities of the right quality are available to those who need them at the right time and for the right cost,” he added.
Dikoloti further indicated that not only do medicines and related health commodities form part of the six building blocks of the World Health Organisation (WHO) framework for health systems strengthening, but they have also been arguably the most important inputs needed by his ministry to be able to provide sustainable diagnostics, preventative, curative, and rehabilitative services to the nation. He added that it made sense that, any significant investments in the supply chain management of health commodities are likely to have a ripple effect on the health outcomes.
However, he pointed out that his ministry was aware of some structural deficiencies that directly affected the efficiency of their supply chains and could negatively impact health. He therefore said several assessments had identified the following challenges in Botswana’s health commodities supply chain management; unstable supply of medicines and related supplies, long procurement process, systemic organisational bottlenecks, outdated legal and policy frameworks, inadequate ICT infrastructure limiting access to end-to-end data visibility, warehousing and distribution challenges at the last mile, and inadequate supply chain skills.
Moreover, the minister explained that the COVID-19 pandemic had a catastrophic impact on the supply chain and availability of health commodities as a result of disruption not only in the transportation of goods but also in the manufacturing of such. He added that this compounded the mentioned challenges hence the unfortunate stock outs of medicines and medical commodities that they experienced over the past year.
“The government of Botswana in an endeavour to improve availability of commodities and services in general, addressed the procurement bottlenecks through the review of the Public Procurement and Asset Disposal Act of 2002 and promulgation of new procurement law. The Public Procurement Act, 2021 among other things reduced the structures for procurement and gave the responsibility for procurement to the Accounting Officers in ministries and other public entities. For my ministry, this enables us to timely respond in the procurement of life-saving commodities, and this Act couldn’t have come at the right time when we are struggling to recover from the aftermath of the COVID-19 pandemic,” he explained.
Dikolti also pointed out that another big supply chain lesson learnt during COVID-19 was the underdeveloped local manufacturing that could not support the health sector with medicines and medical commodities during periods of restricted movements. He said that calls for investment and support of local manufacturing to enhance health system responsiveness, resilience and sustainability in the long term. In recognising the need to build local capacity across sectors, he said the government of Botswana enacted a law that promotes citizen inclusion and empowerment to actively participate in the economy.
Moreover, he acknowledged and appreciated the support provided to the people of Botswana by the government of the United States of America through the United States Agency for International Development (USAID). He said their partnership, through the USAID Global Health Supply Chain Programme-Procurement and Supply Management
(GHSC-PSM) project, had been instrumental in the development of this strategy. Dikoloti added that it was through such collaborations they could make significant strides in their healthcare sector. For his part, the US Ambassador to Botswana, Howard van Vranken, said his country remained a strong and reliable partner to Botswana. He added that the National Supply Chain Strategy was one of the many achievements that brought a strong partnership between the two countries. He added that it would help the MoH improve service delivery on the health side. He also said the supply chain was the key priority in ensuring access to quality health care through the provision of medicines and medical products.