The southern African nation of Botswana may be land locked and unknown to millions of people in America, but it has set many examples on how the HIV-AIDS pandemic can be combated. The country is not only relatively stable compared to some of its neighbors that include Zimbabwe, which has sucked out all good news out of Africa, but it is also a rapidly developing economy and arguably Africa’s most successful nation.
Despite its diamonds, stellar economic record, prudent fiscal management, negligible foreign debt and with growth records of about 5.2 percent, it is one of the hardest hit by the HIV-AIDS pandemic.
According to the United States Center for Disease Control and Prevention (CDC), the current data on the HIV-AIDS prevalence rate in Botswana shows an estimated 24.1 percent of the adult population that is infected with the disease based on 2007 estimates. The country‘s population is about 1.8 million and with a total land surface of 585,000, slightly smaller than the state of Texas. Life expectancy has dropped from 66 years to about 56 years, according to the 2001 CSO (life actuaries) tables. Bases on September 2008 World Bank estimates, the infant mortality has increased from 45 per 1000 births in 1990 to 90 per 1000 births in 2006, with the main cause being the result of HIV-AIDS.
For Ralph Wilmoth, section chief for HIV-AIDs prevention at the Colorado department of Health and the environment, there is still a stigma associated with the disease in Botswana but he says “they are happy to talk about HIV-AIDS; they were all quite willing to have these conversations.”
Wilmoth recently toured three sites in Botswana as part of a United States President’s Emergency Plan for AIDS Relief (PEPFAR) funded campaign of the Botswana Preventions Works, a project of the National Alliance of State and Territorial AIDS directors.
“Those three site visits that I made certainly reinforced in my mind that there is an interest at the community based organizational level and the ability to do HIV-AIDS prevention works,” Wilmoth explained.
Throughout sub-Saharan African, HIV-AIDS remains an issue and posses social as well as economic challenges to many nations. Because of the high prevalence of the disease in parts of Africa, peoples from Africa coming to the United States and those already living in the United States are barred from making blood donations for fear of possible contamination. Such a policy holds not just for Africans but also for anyone in the United States who has had a recent tattoo or have being in contact with certain blood products.
“It is because the likelihood is greater that they might be infected and this is not different than any other public health issue. So, they use data to establish the potential for exposure,” Wilmoth confirms. He is also the AIDS director for the state of Colorado.
Botswana Waging Successful Battle Against HIV-AIDS
Today, HIV-AIDS and other health experts around the world know Botswana not because it is stable, rich and beautiful or a growing economy, but because it is the gem and crown jewel in the fight against the disease. The country is using a combination of prevention activities, traditional grassroots education campaigns as well as programs which target young adults and youths. While some of the programs are well structured, well managed by the locals and with access to a variety of domestic and international funds, citizens lack of knowledge of English in some communities and of basic furniture to equip nice buildings is posing some challenges.
“What we discovered was that they had some really good physical structures, but they did not have any furniture in it,” Wilmoth said.
For its strong HIV-AIDS prevention campaigns and treatment regiment, and yet with little fanfare, the country has attracted support and accolades from global institutions including the US Center for Disease control(CDC), the National Institute for Health and PEPFAR.
When PEPFAR was launched in 2003, Botswana was designated a focus country of the initiative. PEPFAR, with an allocated budget of $15 billion in five years since 2003 and with projections to reach $18 billion, is considered the largest international health initiative in history dedicated to a single disease because of its size and scope.
Under PEPFAR, Botswana has received more than $300 million dollars to help scale up successful programs and launch prevention and treatment campaigns, according to statistics from the US Department of Health and Human Services (HHS).
Today, anti-retroviral drug treatment is given for free to anyone with the disease and there is a nationwide Mother-To-Child prevention program. For both fiscal years (FY) 2004 and FY 2008, Botswana had a 58 percent and 68 percent coverage rate respectively for pregnant women receiving HIV counseling and testing. This was the highest for all U.S. PEPFAR allocated funds designated towards the Mother-To-Child prevention programs under U.S. government support.
The fight to deal with the disease has also earned Botswana recognition for its leadership by the Mo Ibrahim Foundation. The multi-million dollar Ibrahim prize for Achievement in African Leadership was offered to former Botswana president Festus Mogae in 2008. Mogae not only resigned after serving two successful five year terms as president, but was recognized for good governance in the fight against the HIV-AIDS. For that, he is collecting “USD $5 million over 10 years and UD$200,000 annually thereafter” according to the Foundation.
Editor’s note: George Bamu, a native of Cameroon, is an Aurora-based freelance journalist and founder of Africa Agenda, as well as an IT and communications professional. He can be reached through the Africa Agenda web site at www.AfricaAgenda.org.