Thato Chwaane
31 March 2008
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During his tenure President Festus Mogae has made many strides in the health sector, especially on HIV/AIDS. He has been praised for playing a pivotal role and for his commitment in the fight against HIV/AIDS.
Many have said that he will leave a legacy in Botswana's history in prolonging thousands of lives by preventing early death due to AIDS and setting a clear path towards controlling the epidemic.
Mogae coined the phrase Ntwa e bolotse (the war has started) early on. Mogae insisted that the country's population faced possible "extinction" because of AIDS. He then committed his government to procuring antiretroviral drugs (ARVs), with a desire to make them available free of charge to every citizen in need of them in Botswana.
By July 2000, Merck and the Gates Foundation created the African Comprehensive HIV/AIDS Partnerships (ACHAP) and formally joined forces with President Mogae to support the country's already ambitious campaign to combat the epidemic.
Two years later, the first site for ARV treatment was made available free of charge to the people who needed treatment in Botswana. The country has since extended ARV treatment, with the programme being rolled out to 42 clinics nationwide as a way of increasing access to the therapy. While the majority access treatment from the public facility, others access it through private doctors through a public private partnership venture and some get the treatment privately.
By 2004 Mogae adopted a policy of routine, voluntary HIV testing for all people seeking medical care for any condition ("opt out" instead of "opt in"). The policy was a bold decision to have Botswana pioneer routine testing amid heavy criticism from some quarters. This has increased the numbers of people who know their status.
The prevention-of-mother-to-child transmission (PMTCT) as one of the intervention strategies has been effective and curbed transmission to four to six percent with the increase in its uptake. Also introduced was early infant testing, which has been rolled out to the districts and provides accurate diagnosis of HIV at six weeks.
In order to encourage citizens to go for voluntary counselling and testing, Mogae publicly declared that he had tested for HIV. Great strides have been made with the current 93, 754 people on the lifesaving treatment, out of an estimated 115, 000 people who may need it.
Botswana is said to be one of a few countries in the developing world to have attained the Millennium Development Goal (MDG) six whose target is to halt and reverse the spread of HIV seeing by the recent drop in infections among the youth.
However, HIV prevalence rates, both at the national level and especially among the youth, have dropped. The reduction of the HIV prevalence among pregnant women from 37.4 percent in 2003 to 32.4 percent in 2006 is an indication that there is progress in fighting the HIV scourge. In addition, the national prevalence rate for the age group of 18 months and above is 17.1 percent.
Mogae has been at the forefront in getting foreign countries to assist in fighting the scourge, which has resulted in countries like Cuba dispatching health professionals to Botswana.
Organisations that have assisted in the fight against the epidemic include the USA President's Emergency Programme for AIDS Relief (PEPFAR) and the Global Fund. Botswana meanwhile continues to allocate a greater proportion of its budget to this disease, as seen in this year's Development Budget, in the Ministry of State President, with an allocation of P1.918 billion, HIV/AIDS alone accounts for about 43 percent of the ministry's allocation. HIV/AIDS Programme has been awarded P838.4 million.
Amongst other developments that have come up in the last 10 years is the Botswana Harvard Partnership (BHP) established to do world-class research locally. It is the Botswana-Baylor Children's Clinical Centre of Excellence that has made a difference to many lives. The centre is said to be the only one on the African continent dedicated exclusively to the comprehensive care and treatment of HIV-infected children and their families.
The country has also made many strides under Mogae's leadership, with upgrading of hospitals, the setting-up of a medical education programme at the University of Botswana (UB), the commencement of work on a new Faculty of Health Sciences and efforts to establish a medical school.
* Challenges
Health manpower needs are still a big challenge compounded by open global market forces, which makes it difficult to recruit and retain skilled personnel.
The disease burden has resulted in overstretching the limited human and infrastructural resources that are available. There has been an exodus of health workers looking for greener pastures due to unattractive conditions of service.
* Gender
Mogae has been applauded for having more women in leadership roles.
In 2003 the UNDP placed Botswana, alongside Canada, as number 16 in the world in terms of the percentage of women, 35 percent, occupying leadership positions in both the public and private sectors. This placed Botswana above all of the countries in western and northern Europe. The same UNDP Report further stated that 52 percent of those employed in the country in professional and technical fields were women.
The 2007 official figures have shown that female representation in senior decision-making positions in the public sector stood at 41 percent. This figure incorporates all positions at "D" scale and above, including the Attorney General, Director of Public Prosecutions (DPP), permanent secretaries and heads of department and parastatals as well as ambassadors and high commissioners.
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