Public Health Law Botswana Style

For those of you looking for something a little different in your BB diet, this one's for you. I have been spending time with a variety of players in the public health world here in Gabarone. Like all countries, how health policy and law is developed is a byzantine and mysterious process (especially if you are coming at it from the outside). This is a highly centralized system in which the Ministry of Health does a fair amount of micromanagement of the public hospitals for example (Princess Marina being the largest of this group). So many decisions that would in the US be made by some hospital VP or even some mid management person are kicked up and up the ladder to some Ministry of Health person. Last week I met with a senior management officer at the Ministry of Health who is in charge of "outsourcing", basically negotiating the contracts with many of the country's partners to build and service many of its health needs. Botswana is relatively affluent but has not yet had the opportunity to develop its human professional resources, so it needs to import much professional talent. On the other hand, there is a strong desire to put Motswana (Botswana natives) in all available positions. I understand from my contact that new public health acts are under development to modernize their system and look forward to seeing them when they become available.
In another venue I have been meeting with folks from an organization called BONELA (Botswana Network for Ethics Law and Advocacy). They advocate for the rights of HIV/AIDs patients in employment, access to health care, and housing, etc. They are a small NGO and I have agreed to help them with a position paper on a matter of great concern here. Botswana provides universal access to ARV (antiretroviral therapy) for HIV for all "citizens" of Botswana. So the many refugees to the country (many of whom are from Zimbabwe) and also prisoners who are non-Botswana have no access to these drugs. We are trying to come up with some good legal and policy arguments to persuade lawmakers to expand access to non-citizens.
I have also been meetingwith a UB law professor who teaches human rights law and is very interested in the development of research ethics guidelines and regulations - an important concern in countries in which a lot of foreign clinical HIV/AIDs research has streamed in.
Last night we had dinner with a new friend, a Fulbright fellow at UB from
California (USC). She teaches Alternative Dispute Resolution here - we discovered we had frieinds in common ( a frequent occurence in Gabs- crossroads of all nations!). At dinner we also met an American who works for a Belgian political consulting company charged with advising the Office of the President. Many interesting stories of this and former jobs, consulting during the troubles in Rwanda and Georgia.