Botswana has been hard hit by AIDS. In 2009 there were an estimated 300,000 adults living with HIV - or one quarter of the population aged 15 and over. Considering Botswana’s population is below two million, the epidemic has reached disturbing proportions. The country has an estimated adult HIV prevalence among 15-49 year olds of 24.8%, the second highest in the world after Swaziland.1 HIV and AIDS has had a devastating impact on Botswana. Life expectancy at birth fell from 65 years in 1990-1995 to less than 40 years in 2000-2005, a figure about 28 years lower than it would have been without AIDS.
The loss of adults in their productive years has serious economic implications,3 with families being pushed into poverty through the costs of HIV and AIDS medical care, loss of income, and funerals. The economic output of Botswana has been reduced by the loss of workers and skills; agriculture and mining are among the worst affected sectors. The loss of adults to AIDS has also had a significant affect on children in Botswana: an estimated 93,000 children have lost at least one parent to the epidemic.4 It is vital these children have access to education, but this is problematic in families already weakened by AIDS where children may be providing care for ill relatives or supporting siblings.
In an address to the UN assembly in June 2001, President Festus Mogae summed up the situation by saying:
The First National Strategic Framework (2003-2009) spearheaded the multi-sectoral national response, explicitly outlining the implementation responsibilities of all partners and sectors involved and providing them with clear set of structures and guidance. During this time, a number of developments occurred including routine HIV testing, increased VCT centres and the provision of antiretroviral drugs through the public sector.
In 2009 Botswana completed its second National Strategic Framework which will guide its response to HIV and AIDS from 2010 until 2016.9
In 1995 the US Centers for Disease Control and Prevention (CDC) and the Botswana Government began a collaboration called BOTUSA, to work on public health research and programmes to combat TB as well as HIV/AIDS. BOTUSA has grown substantially since 2000, and is now part of the President's Emergency Plan for AIDS Relief (PEPFAR).13 PEPFAR contributed $55 million to HIV/AIDS programmes in Botswana in Fiscal Year 2006 alone.14
With help from these and other partners - including the Global Fund, the Harvard School of Public Health, the Bristol-Myers Squibb Foundation, and numerous faith-based and community-based organisations - Botswana has mounted one of Africa's most comprehensive programmes of HIV/AIDS prevention, treatment and care.
The loss of adults in their productive years has serious economic implications,3 with families being pushed into poverty through the costs of HIV and AIDS medical care, loss of income, and funerals. The economic output of Botswana has been reduced by the loss of workers and skills; agriculture and mining are among the worst affected sectors. The loss of adults to AIDS has also had a significant affect on children in Botswana: an estimated 93,000 children have lost at least one parent to the epidemic.4 It is vital these children have access to education, but this is problematic in families already weakened by AIDS where children may be providing care for ill relatives or supporting siblings.
In an address to the UN assembly in June 2001, President Festus Mogae summed up the situation by saying:
"We are threatened with extinction. People are dying in chillingly high numbers. It is a crisis of the first magnitude."5In response to this emergency, Botswana became the first African country to aim to provide antiretroviral drugs to all its needy citizens. The success of this treatment programme has made Botswana an example for other African nations to follow. Yet even with though it has achieved universal treatment access (that is at least 80% of those who need HIV treatment are receiving it)6, the country continues to suffer greatly from AIDS. If it is ever to defeat the epidemic, Botswana must find a way to halt the spread of HIV.
History of HIV and AIDS in Botswana
Botswana's first AIDS case was reported in 1985. The country's response to the emerging HIV and AIDS epidemic can be divided into the following stages:- The early stage (1987-89) focused mainly on the screening of blood to eliminate the risk of HIV transmission through blood transfusion.
- The second stage (1989-97), and the first Medium Term Plan (MTP), saw the introduction of information, education and communication programmes, but the response was still quite narrowly focused. During this stage, in 1993, the Government adopted the Botswana National Policy on AIDS.7
- During the third stage (1997-2002), the response to HIV/AIDS was expanded in many different directions to include education, prevention and comprehensive care including the provision of antiretroviral treatment. The second Medium Term Plan (MTP II) aimed to involve many stakeholders who had previously been excluded, with the overall goal of not only reducing HIV infection and transmission rates, but also reducing the impact of HIV and AIDS at all levels of society.8
- Since 2003, a national multi-sectoral framework has guided the response, coordinated by the National AIDS Co-ordinating Agency.
The First National Strategic Framework (2003-2009) spearheaded the multi-sectoral national response, explicitly outlining the implementation responsibilities of all partners and sectors involved and providing them with clear set of structures and guidance. During this time, a number of developments occurred including routine HIV testing, increased VCT centres and the provision of antiretroviral drugs through the public sector.
In 2009 Botswana completed its second National Strategic Framework which will guide its response to HIV and AIDS from 2010 until 2016.9
Government and international funding for AIDS in Botswana
In 2008, approximately $340 million was spent on Botswana's HIV/AIDS response.10 The Botswana national government provided 66% of funding for HIV/AIDS programmes that year, a substantially greater share than other sub-Saharan African countries who rely mainly on foreign donors.11 The most significant initiatives supported by foreign donors are the African Comprehensive HIV/AIDS Partnerships (ACHAP) and the BOTUSA project. President George W. Bush meets with President Festus Mogae of Botswana in Gaborone, Botswana
ACHAP is a public-private partnership established in 2000 between the Government of Botswana, the Bill & Melinda Gates Foundation and the Merck Company Foundation. The Bill and Melinda Gates Foundation and the Merck Company Foundation have committed $106.5 million towards the project, in aid of supporting Botswana's HIV/AIDS response, and Merck has donated its antiretroviral drugs Stocrin and Crixivan. In November 2008, Merck expanded its donation to include Atripla and Isentress.12In 1995 the US Centers for Disease Control and Prevention (CDC) and the Botswana Government began a collaboration called BOTUSA, to work on public health research and programmes to combat TB as well as HIV/AIDS. BOTUSA has grown substantially since 2000, and is now part of the President's Emergency Plan for AIDS Relief (PEPFAR).13 PEPFAR contributed $55 million to HIV/AIDS programmes in Botswana in Fiscal Year 2006 alone.14
With help from these and other partners - including the Global Fund, the Harvard School of Public Health, the Bristol-Myers Squibb Foundation, and numerous faith-based and community-based organisations - Botswana has mounted one of Africa's most comprehensive programmes of HIV/AIDS prevention, treatment and care.
No comments:
Post a Comment