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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
Virus Hits at the Country's Life Force
Nicol Degli Innocenti
September 26, 2001
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 Mogae himself.

"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.

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