- Botswana, one of the world's worst AIDS-hit countries, reports successes in its national programme to treat its AIDS patients. Approximately 48 percent of those eligible to receive anti-retroviral (ARV) therapy are now being treated, according to the Botswana government. Botswana's national ARV programme thus has met its targets just four years after the country sought to roll out ARV therapy nationwide.
"On World AIDS Day [on 1 December], people around the world are turning to governments and asking them to 'Stop AIDS and keep the promise'," states Batswana Minister of Health, Professor Sheila Dinotshe Tlou. "Today, the government of Botswana is turning to its people and declaring that it has indeed kept its promise. Not only was the national roll out of ARV treatment completed by December 2004, but we have exceeded our patient enrolment targets," the Minister added.
In 2001, the Gaborone government had commissioned a study which estimated that approximately 110,000 people would be eligible for ARV treatment. "By September 2005, Botswana has 4,582 children on ARV treatment under the National programme, with a total of 54,378 people receiving treatment via the public and private healthcare systems. This has resulted in 48 percent of all eligible ARV candidates in Botswana receiving life-saving ARV treatment," Ms Tlou adds.
Botswana was one of the few countries to implement a national ARV programme prior to the introduction of the World Health Organisation's 3 by 5 initiative and "there is firm indication that the national programme is proving to be a success," according to the Batswana government.
"What is even more heartening is that we are beginning to see a change in attitude," states Mr Ramotlhwa, operations manager for the Masa ARV programme. "Masa" is a Setswana word for "dawn" to signify the hope ARV offers people living with HIV and AIDS to live longer, healthier lives by providing people living with HIV/AIDS with "time to nurture their families and to build a future for the nation."
"Batswana are finally understanding, that regardless of their HIV status, they have viable options available to them to continue seeking and living fulfilled lives. This attitudinal change is certainly reflected in the increased number of people coming forward for HIV testing," Mr Ramotlhwa adds.
The leader of the Masa programme points to statistics. "230,356 people visited Tebelopele Voluntary Counselling and Testing centres between January 2002 and October 2005. This is a significant increase given the fact that only 18,930 people had tested at Tebelopele centres prior to 2002," Mr Ramotlhwa states.
"Furthermore, in the first six months of this year, 74,134 people were tested via the routine HIV testing programme. This is much greater than the 69,250 people who were tested under routine HIV testing during the whole of 2004. This shows that routine HIV testing is proving to be an important entry point for ARV therapy."
"Historically stigma has played a significant role in hindering people coming forward for HIV testing. The marked increase in HIV testing could indicate that this negative influence is abating as more and more people realise the ‘hope’ that ARV therapy can afford them," concludes Mr Ramotlhwa.
Botswana, which has an HIV prevalence rate among the economically active population of above 35percent, introduced the Masa ARV medication programme in the public healthcare system in January 2002. ARV therapy is now available in 32 sites across the country. As of September 2005, approximately 45,554 patients are on treatment under the Masa programme, with an estimated additional 7,280 patients receiving treatment through the private sector, for a total of 52,834 Batswana on treatment.
While ARV treatment has raised hope among the many Batswana infected with HIV, critics however hold that the focus on rather expensive therapies is taking away the focus from the biggest problem - the continued spread of HIV. Despite years of public information campaigns, sexual attitudes in Botswana have not changes significantly. National infection rates continue to rise.
This problem is also somewhat recognised by the leaders of the ARV programme. "Whilst the role of ARV therapy in fighting the battle against AIDS cannot be disputed, it cannot stem the tide of the HIV/AIDS crisis. We have to solve the problem from the source," states the African Comprehensive HIV/AIDS Partnerships (ACHAP) project leader, Mrs Fantan.
"ARV therapy plays an important role, however it must be seen as one component of the bigger prevention picture," Mrs Fantan adds. "In this light, ACHAP, being an important partner of the national ARV programme, will continue its support, whilst encouraging stronger links between treatment and prevention programmes," she concludes.
The African Comprehensive HIV/AIDS Partnerships (ACHAP) was formed in July 2000 to advance HIV/AIDS prevention, care, support and treatment in Botswana. ACHAP is a public-private development partnership comprised of the government of Botswana and foreign humanitarian foundations.
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