Boston Globe (10.24.03) - Tuesday, October 28, 2003
In June, Botswanan President Festus Mogae feared the worst
after he fell ill and began to grow thinner: AIDS. "I
concluded I must have the virus. I was psychologically
prepared," Mogae said in an interview. Mogae said he was
screened for HIV and relieved to find he tested negative. The
diagnosis was stress-related diabetes.
Mogae's frank comments - no other African leader has come
close to such an acknowledgement - distinguish him from other
presidents in sub-Saharan Africa, where more than 30 million
people are believed to have HIV/AIDS.
In the nation with the world's highest HIV infection rate last
year, Mogae recently took the step of informing the public,
through a televised address, that hospitals and clinics would
begin routine AIDS testing for everyone seeking treatment for
any malady, although a patient could refuse the test. The
policy is a first for Africa.
But in an interview Thursday, Mogae went further and said that
doctors and nurses should go ahead and test patients unless
specifically told not to, and that health workers should not
ask whether a patient wants to be screened. In some cases,
doctors or nurses could refuse treatment if patients refused
to be tested for HIV.
Botswana offers free antiretroviral drug treatment for those
with HIV/AIDS, but only 9,000 of the 100,000 who need the
drugs are taking them. The coordinators of its program have
said that the greatest impediment to its expansion is that
many people do not know they are infected, as too few people
are coming in for testing.
While complimenting Botswana's plan for routine testing in
hospitals, Paul S. Zeitz, executive director of the Global
AIDS Alliance, said withholding treatment would be