HIV/AIDS Prevention and Treatment in Botswana
The AIDS crisis shook the world in the 1980s, but some countries, including Botswana, are still trying to find their footing in terms of HIV/AIDS prevention and treatment. HIV/AIDS prevention and treatment in Botswana has been a struggle, but the country is taking the right steps forward to fight the virus.

HIV/AIDS Prevention and Treatment in Botswana

Botswana has the fourth-highest rate of HIV in the world, with a rate of 20.3%. In 2000, the peak rate was 26.3% and rates have decreased every year since. The National AIDS Coordinating Agency created a treatment plan to offer universal free antiretroviral treatment (ART), making Botswana the first country in the Southern African region to do so. This effectively reduced the rates of HIV in Botswana.

This first strategy for treatment is simple. The test and treat strategy gives people who test positive for HIV access to immediate treatment. With enough treatment, HIV levels can become so low that they are undetectable on a test. However, this does not mean treatment should be stopped. Continued treatment is necessary in order to maintain an “undetectable viral load,” which means the chance of a person transmitting HIV is zero.

Women and HIV/AIDS

More than half (56%) of people who have HIV in Botswana are women. HIV disproportionately affects women in Botswana for reasons including sex work, forced marriage, domestic violence and more. Botswana’s HIV prevention strategy includes offering protective solutions as 85% of condoms available in the country are free. However, the country’s sex education is vague and does not cater to women or young people.

Many women contract HIV at a young age because of forced youth marriage, domestic violence and more. Botswana’s sex education program holds ideas such as faithfulness and cultural traditions as the basis of its programs. Without comprehensive and adequate sex education, Botswana’s HIV rates remain high even though treatment is easily accessible.

HIV’s disproportionate effect on women in Botswana triggered the creation of a second treatment plan called Option B+. Option B+ functions similarly to the test and treat strategy, but is specific to women. Since women can pass HIV on to children, after a woman tests positive for HIV once, she receives ART for the rest of her life under Option B+, regardless of whether the HIV becomes undetectable on a test. This lowers the chance of a woman passing HIV on to a baby, which reduces HIV rates among the general population.

Looking Ahead

Botswana’s treatment plans for HIV and AIDS using ART transformed the country from struggling with an epidemic to having a strong plan for it. As of 2017, out of 380,000 people who had HIV in Botswana, 320,000 of them had access to treatment. Botswana is on its way to ending AIDS as a public health threat through its treatment plans.

– Sana Mamtaney
Photo: Flickr

Botswana's Success
Botswana is a landlocked country with an economy heavily based in the mining industry, having discovered diamonds around the time of independence. This subsequently kickstarted a parting from its agricultural and farming sectors. Botswana also depends on foreign trade with countries such as South Africa and Mozambique. Throughout the past 40 years, Botswana’s success has been startling in the face of the underdevelopment that often plagues other African nations. From 1985 to 1994, the number of impoverished people decreased by 17 percent and by 1990, child mortality rates had dropped from 18 percent to 4.5 percent for Africa as a whole.

Maintaining Progress

Many have largely viewed Botswana’s success as a shining star in the narrative of post-colonial Africa, and rightfully so. Since its independence in the 1970s, Botswana has maintained democratic institutions, a relatively stable and growing economy, inclusive social constructions and avoided the violence of civil war that has plagued its neighbors for decades. This country exemplifies the importance of establishing inclusive institutions to positively affect development through policies that aim to hold its leaders accountable and remain based in a market economy.

As an example of hope in an otherwise tumultuous sub-Saharan Africa, Botswana’s success is somewhat due to luck and chance. Historically, the discovery of diamonds and other reserves of natural resources has resulted in high levels of corruption and economic instability. Botswana instead had leaders who chose to allocate profits from the diamond sector to fund government programming. The country was able to rewrite its story after colonial rule and avoided the strife that often comes out of independence. It is difficult to find objective reasons as to why Botswana’s success has been so largely beneficial when the events that led to prosperity seem circumstantial.

Botswana’s Influence and Place

Some often raise questions about the reasoning behind Botswana’s growth and the answers to these mostly point to the critical instance of having good leaders working to develop a system of government that thrives on government accountability; something that many other African governments have not yet achieved. The emphasis on Botswana as a model for African success is blatant and justified, however, it is important that while it has been widely profitable and stable, the establishment of institutions comes with problems. Unemployment rates are high due to a disparity between the number of educated people and jobs available and HIV/AIDS rates are among the highest in the world. Additionally, while the economy has been doing well, it is not diversified.

Botswana’s success is a model for the possible future for sub-Saharan Africa. To assume that other countries currently transitioning from the post-colonial rule are the same in establishment and practice would be to discount individual differences that differing cultural and societal norms display. But, Botswana is an exception, and there is something to gain from discussing and analyzing its place as a nation in Africa. The success story of this country is an example of hope for a better future for other African countries struggling after extractive colonial rule and presents an opportunity to see Botswana as an example of a nation in the developing world.

Jessica Ball
Photo: Pixabay

HIV/AIDS in Botswana

Botswana is a landlocked country in Southern Africa that is bordered by South Africa, Zimbabwe and Namibia. It has a relatively stable economy, boasting the fifth highest GDP per capita in Africa. However, in 2019, Botswana had the third-highest rate of HIV/AIDS in the world with 21.9 percent of the population living HIV positive. This article will discuss the efforts that the government of Botswana and other global companies and organizations have made to help bring this epidemic to a halt.

“Masa” Program

HIV/AIDS rates have been steadily declining every year in Botswana since 2000, when the HIV/AIDS epidemic reached its peak in the country with 26.3 percent of people testing positive. In 2001, Festus Mogae, the President of Botswana at the time, pledged to devote significant resources towards stopping the spread of the virus. In 2002, through a partnership with the Botswana government, the American pharmaceutical company Merck & Co offered to donate antiretroviral therapy drugs (ART) free of charge to individuals in communities throughout the country. By 2013, the program, called “Masa,” had reached more than 220,000 individuals.The Masa program also helped fund infrastructure development and health care professional training. In addition, new treatment centers and resource centers were constructed to help treat patients and contributed to the decline in HIV/AIDS rates.

UNDP Efforts

In 2010, the United Nations Development Programme (UNDP) entered into a cost-sharing agreement with the government of Botswana. The agreement called for increased funding to help improve the capacity and effectiveness of HIV/AIDS treatment in the country. So far, the agreement has helped to improve Botswana’s institutional capacity to fight HIV/AIDS. In addition to these efforts, in 2010, the UNDP, in conjunction with the Unified Budget Results and Accountability Framework (UBRAF) helped fund additional HIV/AIDS prevention efforts. These efforts included a commitment to reduce the stigma of using HIV/AIDS-related services. This program has been successfully implemented in various communities across the country.

“90-90-90” Targets

In 2011, UNAIDS set what they dubbed “90-90-90” targets for the year 2020. The goal is to diagnose 90 percent of individuals with AIDS, have 90 percent of diagnosed individuals on antiretroviral therapy (ART) and ensure that 90 percent of individuals with AIDS achieve viral suppression. Botswana has already achieved these targets, as have other countries including Cambodia and Denmark. This is a testament to the commitment made by the Botswana government to fight HIV/AIDS.

New Health Strategies

In 2017, of the estimated 380,000 people diagnosed with HIV/AIDS in Botswana, almost 320,000 had access to treatment. However, in June 2019, President Mokgweetsi Masisi announced a renewed commitment to fighting HIV/AIDS in Botswana. This renewed focus includes two new five-year health strategies — the Third National Strategic Framework for HIV/AIDS and the Multi-Sectoral Strategy for the Prevention of Non-Communicable Diseases — to help further tackle the problem of HIV/AIDS in Botswana. These health strategies are set to be reevaluated in 2023.

– Hayley Jellison
Photo: Flickr