Financial Times (London) (09.26.01) - Wednesday, September 26,
Botswana has the unenviable record of being the country with
the highest infection rate for HIV/AIDS in the world. With
more than 38.5 percent of the sexually active population
between ages 15 and 49 HIV-positive, the disease threatens to
undermine all of the economic and development gains the
country has made in the last two decades.
President Festus Mogae has implemented a comprehensive, multi-
sectoral, nationwide program to combat and prevent AIDS
through a relentless education campaign, free condom
distribution, voluntary testing and counseling, and most
recently, antiretroviral therapy. HIV-positive pregnant women
have access to drugs that reduce the likelihood of
transmitting the disease to their children. Before the end of
the year the government will offer antiretroviral medicines
free to AIDS patients through the public health service.
Every government department has been mobilized, at central and
local levels, at great cost to the government -$580 million
until 2004. The Minister of Health said, "There is a huge cost
to the economy in leaving the situation as it is. We are
investing in antiretroviral drugs so that we have the skills
to expand economic growth."
Many international players have contributed to the effort,
including the UN Development Program; philanthropists like the
Bill and Melinda Gates Foundation; pharmaceutical companies
like Merck and Boehringer-Ingelheim; and many non-governmental
agencies. But the driving force behind the plan is President
"Political will is crucial to success, because local
authorities will always dance to the king's music," says the
Rev. Edward Baraloemwa, national coordinator of the Botswana
Christian AIDS Intervention Program. "That is why I am
confident we are on the right track. The Church is doing its
part, trying to dispel the belief that AIDS is a punishment
from God and that people should not tamper with God's will.
The stigma is still there, but has been diminishing. Things
are moving in the right direction."
But stigma is still strong. According to one doctor, "We pick
up our patients in an unmarked van, so that the neighbors will
not know they are HIV-positive and turn against them." And
there is a chronic shortage of doctors and nurses.
Yet, word is spreading and many are now volunteering to help
the effort. According to Patricia Bakwinya, who now works
full- time for Tshireletso, an AIDS center she opened in 1999,
"We went from house to house, from funeral to funeral, from
bar to bar. Now people come to us for information, advice, and
counseling. They no longer automatically believe that if you
have AIDS it is because you have been cursed. Everyone knows
about AIDS by now. But most people prefer not to know their
status, because there is nothing they can do anyway."
Bakwinya adds, however, that the despair will change with the
introduction of antiretroviral drugs. "People will want to be
tested in the knowledge there are drugs that will prolong
their lives and make them feel better. This prospect is giving
people a lot of hope." Compared to neighboring South Africa,
where debate seems to have replaced intervention and
discussion has been substituted for policy, Botswana is a
beacon of hope.