The International Commission of Jurists and Amnesty International have been pressing Botswana’s Ministry of Health and Wellness to make public its official Covid-19 vaccine roll-out strategy, yet their request has so far fallen on deaf ears. Unless Botswana rapidly produces a sustainable, workable strategy the country faces the prospect of devastating Covid-19 figures.
Mandipa Machacha is a researcher on economic, social and cultural rights at Amnesty International’s Southern Africa regional office.
Tim Fish Hodgson is a legal adviser on economic, social and cultural rights for the International Commission of Jurists.
In the past few weeks, Botswana has recorded some of the highest Covid-19 transmission rates on the African continent. This debilitating third wave of infections has come at a time when the country’s inhabitants remain inadequately protected, with only 5.5% of the population fully vaccinated and a further 4.8% having received a single vaccine dose. Hospital mortuaries are reportedly at maximum capacity and deaths as a result of Covid-19 continue to rise.
In late July, infections in Botswana reached their peak. The World Health Organization (WHO) reported that the country registered 4,566 new cases on 30 July, with a reported positivity rate of 641 infections per 100,000 people in the preceding seven days. Compounding the country’s low vaccination rate, Botswana now also faces the unenviable situation of having a very low Covid-19 vaccine supply.
It is in this context that the confused government messaging on vaccine acquisition and roll-out, and its inadequate planning needs to be evaluated.
In May 2021, the President of Botswana Mokgweetsi Masisi assured the nation, and the world, that the country had secured sufficient Covid-19 vaccines for the entire adult population. However, the president’s message has recently changed given the severe shortage of vaccines, and he has now indicated that Botswana can only expect to receive additional doses “by December 2021” and anticipates that all those who are eligible will be vaccinated “by the end of 2022”.
Thus, the majority of people in Botswana are likely to face several more waves of Covid-19 without the protection afforded by vaccines.
In recent weeks social media users in Botswana using the hashtag #VaccinateBotswana have put increased pressure on the government to improve the pace of its vaccine roll-out, while several thousand people have already signed an online petition demanding greater transparency on the government’s Covid-19 strategy, including its dealings with pharmaceutical companies.
Health workers’ unions have also voiced their concerns about Botswana’s vaccination roll-out, with the Botswana Nurses’ Union, for instance, stating that more than “800 nurses have tested positive, and 23 nurses have died due to Covid-19 related complications”.
Frustration is also mounting among educators as they await vaccination, with the reopening of schools scheduled for 17 August. In early July, the two teachers’ unions, Bosetu and BTU, initiated litigation seeking to stop the government from insisting on in-school teaching without first vaccinating teachers.
In the desperate rush for vaccines, the Botswana government, like many other governments around the world, appears to have abandoned some basic principles of stewardship and public health such as forward planning, transparency, consultation with civil society and clear communication with the public.
In general, as a Transparency International report shows, secrecy has been the modus operandi of governments and pharmaceutical companies alike throughout the world. Both data from clinical trials on Covid-19 vaccines and contracts between governments and pharmaceutical companies spelling out how many vaccines will be provided, when and at what cost, have been kept private — often in contravention of domestic procurement laws.
Importantly, even when vaccines are acquired, governments in southern Africa often appear not to have clear strategies and plans for roll-out with prioritisation contrary to guidance published by the World Health Organization as early as September 2020.
At the request of local human rights organisations, the International Commission of Jurists (ICJ) and Amnesty International began contacting Botswana’s Ministry of Health and Wellness in early April to request a copy of the official government strategy on the Covid-19 vaccine roll-out. Despite repeated follow-up communications since, and after being referred from one government official to another, this request has still not been answered.
In the interim, and alongside public health experts and human rights defenders from across the SADC region, both the ICJ and Amnesty International have published reports on the dire state of Covid-19 vaccine access in southern Africa. We have also written to the Chairperson of the SADC, Lazarus Chakwera, imploring him to ensure that the SADC issues a resolution at its upcoming summit, calling on all states to develop and publish comprehensive national vaccine acquisition and roll-out plans.
Under international law, everyone has a right to access Covid-19 vaccines. This application of the right to health to vaccine access in the context of Covid-19 is supported by the African Commission on Human and People’s Rights in its responses to the Covid-19 pandemic.
It is also implicit in the African Union’s decision to fully support the proposal under consideration for the World Trade Organization (WTO) to implement a waiver to the international TRIPS treaty. That treaty protects the intellectual property interests of businesses such as vaccine-producing pharmaceutical companies’ agreements but allows for exceptions and flexibilities to protect the right to health. The proposed waiver would effectively suspend provisions of the treaty to allow for more affordable and equitable vaccine access worldwide.
As well as taking all necessary measures to procure and distribute vaccines, the Botswana government must comply with its human rights obligations in terms of the right to health and communicate which vaccines it has purchased, at what price, when they will arrive and how they will be prioritised and distributed.
In the absence of a clearly communicated, well-publicised, comprehensive vaccine acquisition and roll-out plan, it remains difficult for Batswana to evaluate the adequacy of the government’s plan. Equally, it is impossible to measure Botswana’s actions against human rights law and standards to which Botswana is bound, and for people to access effective remedies in the event that the plan (or its implementation) falls short of the human rights protections to which they are entitled. DM/MC