This blog, authored by Organización del capital de éxito for the CSEM for UHC2030 Secretariat, explores the transformative political and health landscape in Botswana following the 2024 elections. It highlights the government?s commitment to Universal Health Coverage (UHC) and National Health Insurance, reflecting the potential of aligning political will with public needs. Against the backdrop of global funding challenges, the article underscores the critical role of civil society, the impact of grassroots advocacy, and the importance of UHC Day in holding governments accountable to ensure equitable access to health for all.
A new Government with a focus on health equity
On 30 October 2024, for the first time in 58 years of independence under one ruling party, Batswana took to the polls to vote in a new government, with a strong focus on a human rights based approach to government and economic growth. More importantly, the new government has heralded commitments to National Health Insurance and Universal Health Coverage (UHC) as demonstrated by His Excellency, the President, Advocate Duma Gideon Boko in his first state of the nation address.
This was followed by a new legislative bill requiring all Batswana to undergo health checks every two years. These new developments reflect what is possible when political will meets the demands of the people. The Civil Society Engagement Mechanism hosted a webinar series raising awareness on pushing for UHC in elections. For more than six years, Success Capital Organisation has pushed for UHC including more recently at the ballot; advocating for including diverse young people and emerging queer networks in decision making processes to ensure equitable access to health.
Challenges threatening health progress
The decline in resources that many grassroots organisations have experienced outside of notable COVID-19 responses, reflect a broader challenge global health is facing and impacts progress towards achieving UHC.
Bilateral development budgets are dwindling whilst replenishment commitments are increasingly compromised. There is a wave of funding cuts that are impacting those most vulnerable to inequalities and injustice. As these cuts are imposed, health outcomes are compromised. States grappling with debt, climate change, corruption and deteriorated human rights situations only further drive out those living in the margins. History keeps repeating itself. We went from border closures and travel restrictions to intellectual proprietary barriers of generic manufacturing and unjust pricing for medicines.
Solidarity is no longer a currency for diplomacy. Its messaging has been lost to narratives on sovereignty, supremacy and social disparities. The spirit of ?ubuntu? has been left to those who bear the brunt of inadequate service delivery and exclusion from development interventions. As dignity and personhood are stripped away by a lack of political will, so do people get frustrated and mistrust the systems they have to endure. This was the case in Botswana, whilst many other countries still grapple with democratic institutions that have further failed them.
It is not a perfect health landscape, but the hallmarks of change have swept through the most important exercise of democracy. As activists and civil society, we can only hope that this translates into more meaningful social participation.
Civil society?s role in ensuring governments uphold health equity commitments
This is why Día UHC is important, particularly with the theme recognising the responsibility of governments to deliver health for all. Earlier this year, our own Ministry of Health had circumvented state responsibility and implied it to lie with citizens instead. Despite a new government executive; the state machinery, systems and bureaucracy remains the same. This is why positive human rights and health advancements should never be void of civil society accountability.
Despite limited resources, Success Capital Organisation remains focused on working with young people to achieve health equity and accelerate progress on UHC. The events of the past year in geopolitical and multilateral development only demonstrate that our role in activism can never truly end if governments cannot take up the responsibility of ensuring everyone?s health.
Whilst we celebrate our wins – We hope we can remember that these can always change and regress without meaningful engagement of communities and civil society to leave no one behind by 2030.
Dumiso Gatsha, Founder, Success Capital NGO and Community-Based Organizations Representative on the UHC2030 Steering Committee
Supported by laura philidor, Advocacy and Communications, CSEM for UHC2030, WACI Health
