How Botswana is turning HIV on its head

What do you do when you realise that your country has the 3rd highest HIV prevalence in the world 이그니션 다운로드? You don’t panic. Instead, you open 650,000 voluntary testing service centres, and that’s just for starters.

In 2005, more than a quarter of Botswana was HIV positive! This was more than just a health crisis – if left unchecked, this was going to impact the country’s future socially and economically. So, the government decided to take steps.

Routine testing options

In 2004 routine HIV testing was introduced as part of check-ups in private and public clinics – people do have the right to opt out. Botswana was the first country in Africa to have a national policy of routinely offering an HIV test at clinics.

HIV prevention programmes

Aimed at improving the teachers’ knowledge and understanding, a teacher-capacity building programme was developed, and included:

  • All primary and secondary schools being equipped with a video recorder, a television and other resources.
  • Talk Back, an interactive AIDS education programme being aired twice a week by Botswana television. To date, Talk Back has reached more than 460,000 students and 20,000 teachers.

Mass media interventions

The popular Makgabaneng long-running radio serial is one example of how Botswana has utilised mass media for HIV prevention interventions. Makgabaneng has moved beyond just a radio programme and now provides information at road shows – the series covers various themes that relate to HIV and AIDS, such as cultural traditions, HIV treatment and faithfulness.

Mother-to-child transmission prevention

One of the most successful programmes within Botswana’s HIV response has been the prevention of mother-to-child transmission (PMTCT) programme. Look at these numbers;

  • 2013 estimates reported that 11,000 pregnant women were living with HIV and 10,648 of those women were receiving antiretroviral treatment – more than 95% antiretroviral treatment coverage!
  • Since 2009, the percentage of HIV-positive women who are delivering has reduced from 13,000 to 11,000
  • New child infections have dropped to below 500.31
  • The PMTCT programme has launched one of the world’s first triple antiretroviral prophylaxis programmes and currently operates in 634 healthcare facilities around the country.
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Antiretroviral treatment (ART)

Botswana was the first African country to establish a national HIV treatment programme. Launched in 2002, Botswana’s Masa antiretroviral treatment programme is free and available to all eligible citizens. In 2013 it was covering around 214,000 adults living with HIV were receiving antiretroviral treatment – a coverage of 69%. Among children, coverage has risen to 84%, and it has also been highly effective at providing treatment for pregnant women.35

Botswana is close to reaching the UNAIDS 90-90-90 targets! Research in 30 rural communities found that 70.3% of people living with HIV surveyed had achieved viral suppression – very close to the UNAIDS target of 73%.

Factors like less external funding and needing to reach more people are the big future challenges facing programmes like Masa.

The learnings and pay-off:

Faced with an almost overwhelming health crisis, Botswana stepped up and responded by:

  • Recognising the crisis
  • Educating educators, learners and the public in general regarding HIV, AIDS
  • Reducing stigma
  • Making resources available, such as accessible testing centres and universal treatment

And the pay-off for Botswana’s efforts shows in all the numbers: new infections have decreased from 15,000 in 2005 to 9,100 in 2013, AIDS-related deaths have reduced from 14,000 in 2005 to 5,800 in 2013, and HIV prevalence has dropped from 25.4% in 2005 to 21.9% in 2013!