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Monday, July 15, 2002 - Web posted at 9:44:21 am GMT
Tackling the world's worst AIDS crisis"AIDS is the main topic of conversation among ordinary people in Botswana these days. It is threatening the very fabric of our society," said Edmund Dladla, the outgoing national coordinator of the Botswana Network of People Living with HIV/AIDS. HIV is short for the human immuno-deficiency virus which causes AIDS and is transmitted via the bodily fluids of an infected person. "It has reached the point where there is hardly anyone around here who does not know someone who has died of AIDS, or who is HIV-positive ... People are scared," Dladla said. Botswana is the most severely affected country, per capita, in the world, according to UNAIDS and the government's own statistics. For a country roughly the size of Germany with a population of just 1.6 million people, the government has calculated an overall HIV prevalence rate of 38.6 percent. The UNAIDS figure is 35.8 percent. Put another way -- roughly one in three adults is infected. In the capital Gaborone, among those aged between 15 and 49, the prevalence rate is still higher at 44 percent, and for the country as a whole, life expectancy between 1998 and 2010 is expected to drop from 64 to 42 years. Health authorities expect infant mortality to increase from 41 to 65 for every 1,000 births due to AIDS. With these figures in mind, President Festus Mogae used the word "extinction" last summer in an address to world leaders attending the first UN General Assembly meeting devoted solely to AIDS in New York. Describing Botswana as the most "hideously affected" country in the world, he said the pandemic was not abating: "We are threatened with extinction. People are dying in chillingly high numbers. "It is a crisis of the first magnitude." He has repeated these words frequently in nationwide broadcasts in recent weeks. The soft-spoken Mogae, 63 -- an Oxford-educated economist and former finance minister, who replaced Sir Ketumile Masire as president in 1998 -- has devoted much of his five-year term to the AIDS crisis. In a carefully planned strategy to curb the spread of HIV, and its particularly virulent and drug-resistant, heterosexually transmitted local strain, HIV-1C, his government has methodically revamped the national health system to provide nationwide free care. Western donors and the United Nations have praised this strategy. It is centered on four AIDS referral centres at major hospitals, and with a system of smaller clinics throughout the country, no-one today lives more than eight to 15 kilometres (4.8 to 9 miles) from help. The government set a target of 19,000 people for enrolment in their first year of anti-retroviral (ARV) treatment under a 27.5 million dollar rolling programme. The ministry of health has calculated the cost of the drugs, treatment and counselling at about 600 dollars per person, per year. The government has applied for financing of 30.5 million dollars from the UN Global AIDS Fund and has been told it will be successful. Testing and monitoring of Botswana's AIDS plague is carried out by the new Botswana Harvard Reference Laboratory at Gaborone's Princess Marina Hospital, the first of its kind in Africa -- with gene sequencers and blood cell sorters to monitor the spread of HIV. Officials are optimistic that with a nationwide advertising campaign similar to that in Uganda a decade ago, they can reverse the spread of AIDS. The government has pressed the diamond industry, major banks, transport companies and even fuel stations to provide better levels of health care and make HIV counselling available free to employees. "We have found that Botswana can afford to sustain this scheme even though the drugs are needed for life," said Catherine Sozi, a British-trained Ugandan doctor working for UNAIDS. But she has no illusions that Botswana faces a tough struggle in reaching its goal of stopping new infections by the year 2016 - the 50th anniversary of the country's independence from Britain. |
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