Experts join forces for NCD prevention and control in Botswana

The latest non-communicable disease (NCD) investment case was launched in Botswana and hosted by the Ministry of Health and Wellness on the 16th July 2021. Over 100 experts joined this multistakeholder event from the Government, academia, civil societies and the UN to discuss opportunities and challenges in scaling up an effective response to prevent and control NCDs in order to improve health in Botswana.

The investment case, under the Task Force’s WHO-UNDP flagship programme, reviewed prior data on NCDs in Botswana and agreed that the scale of the problem required urgent attention. NCDs such as cancer, cardiovascular disease, diabetes and chronic respiratory disease and their risk factors (tobacco use, harmful use of alcohol, unhealthy diet and physical inactivity) are an increasing public health and development challenge in Botswana. In 2016, NCDs were responsible for 46% of all deaths in the country. With the COVID-19 pandemic disrupting critical NCDs services and evidence suggesting that individuals with NCDs are at a higher risk of disease severity and death, response has never been more urgent for health security.

The Minister of Health and Wellness Dr Edwin Dikoloti thanked the UNIATF for conducting the investment case and partners and stakeholders for willingness to work with government. In an effort to prioritize NCDs, the government of Botswana has made a deliberate decision to move the health promotion aspect of NCDs to the National AIDS and Health Promotion Agency (NAHPA) so that lessons learnt during the HIV and AIDS epidemic response will be applied firsthand, in the fight against NCDs.

The investment case, which is being funded by the Russian Federation, is critical to generating greater action. As stated by H.E. Andrey Kemarskiy, Ambassador of the Russian Federation to the Republic of Botswana in his speech at the event: “An investment case for NCDs will help to better understand the NCD burden in Botswana, provide rationale and support for significantly increased investments in clinical and preventive interventions.”.

The team leading the investment case described how NCDs not only contribute to health care costs, but are a significant socio-economic drain to individuals, families and communities. The preliminary findings presented at the event, suggest that government expenditure on health care for NCDs of USD 226 million (2.5 billion BWP) is just the tip of the iceberg. The indirect (hidden) costs from, premature mortality and lost productivity (absenteeism, presenteeism) are almost five times higher. In Botswana, the cost of presenteeism alone, USD 226 million (BWP 2.6 billion) is 4% more than the total health expenditures on NCDs. Altogether, the economic cost of NCDs to the Botswana economy is USD 1.2 billion (BWP 13.2 billion) per year, which is equivalent to 5.92% of the country’s annual gross domestic product.

The forum agreed that it is critical that sectors beyond health are involved in the national NCD response if Botswana is to achieve the NCD-related SDG targets. Critical too, is the engagement of civil society organizations and the private sector. The findings will be part of a report that the investment case team is putting together, which will also describe the economic and broader societal costs of NCDs to Botswana, as well as the return on investment from scaling up action.

The question for the investment case team is how much are NCDs costing Botswana and her people? And importantly, what are the ‘best buy’ interventions that if properly financed will sustain economic growth and reduce the disease burden, along with the costs of turning things around? These are questions that require answers urgently – and ones that the team will be focusing on in the coming weeks.