In an address to the United Nations assembly in June 2001, at a time when many of his continental peers were either denying or ignoring the horrors of HIV/AIDS, Mr. Mogae candidly stated: “We are threatened with extinction. People are dying in chillingly high numbers. It is a crisis of the first magnitude.”
In 2001, it was estimated that almost 40 per cent of Botswana’s adult population were infected with HIV. With the country having no coherent strategy to confront the disease, thousands of people were becoming infected, ill and dying.
A year later – again while many of his peers were hesitating – President Mogae’s government became the first on the continent to provide life-prolonging medicine to its HIV-positive citizens, free of charge.
And in 2003, Botswana embraced the US President’s Emergency Plan for AIDS Relief (PEPFAR), designed to prevent and treat HIV/AIDS.
At a function in Washington, John Hamre, the chief of a leading US think-tank - the Center for Strategic and International Studies – paid tribute to Mr. Mogae, and said America could learn a lot from Botswana’s leader as a result of his “visionary” leadership in confronting HIV/AIDS.
“We have an opportunity to hear about a man and a government that is getting something done, and getting things done very, very well. President Mogae, you have a global reputation for having tackled one of the hardest problems facing society, and to have found practical solutions that work. And that’s statesmanship, frankly, that we need in America. And I’m delighted that you can be here as a bit of a role model for us,” Hamre said, in introducing the president to the audience.
Mr. Mogae acknowledged that he’d received a lot of American help for his anti-AIDS initiatives. The Bill and Melinda Gates Foundation and the Merck Company Foundation, for examples, had contributed millions of dollars to Gaborone’s efforts, and Merck had also donated antiretroviral drugs. In fiscal year 2006, PEPFAR contributed $55 million to HIV/AIDS programmes in Botswana. Together with these and other partners, health experts agree that Botswana has embarked upon one of Africa’s most comprehensive programmes of HIV/AIDS prevention, treatment and care.
In Washington, President Mogae detailed some of his country’s “modest” successes in combating HIV/AIDS.
“Today, over 90,000 patients are receiving treatment under the national ARV (antiretroviral) program, out of the national target of about 95,000, by the end of 2007. I am confident that we will have reached – or even exceeded – our target, by far, by the end of the year. The prevalence rate among pregnant women has declined from a horrendous 37.4 per cent in 2003, to 32.4 per cent in 2006 – a modest decline, but a trend we expect will persist,” Mr. Mogae explained.
“We also witnessed a significant progression of the probability of HIV transmission from mother to child, from 40 per cent in 1999, to six per cent in 2006. This means that at least 94 per cent of newly born babies are likely to be born HIV-free – an opportunity to achieve an HIV-free Botswana by 2016,” the president enthused.
According to AVERT, an international health monitoring organization, at least 270,000 Botswanans were living with HIV in 2005. This, in a country with a total population below two million, has given Botswana an adult HIV prevalence rate of more than 24 per cent - the second highest in the world after Swaziland.
Mr. Mogae acknowledged that Botswana was “far from out of the woods” with regard to its AIDS epidemic.
“Botswana is still one of the countries worst affected by HIV/AIDS. The impact of this scourge on the economy, and the people, is both evident and severe. The scale of the epidemic has caused us to divert resources away from regular development projects and programs, to the HIV/AIDS national response programs – thus making it imperative that we look to friends such as America and others for support to combat this scourge and keep the country on a sustainable development course.”
But he maintained that there were a lot of reasons to remain positive about Botswana’s future in terms of HIV/AIDS.
“A program for the prevention of mother-to-child transmission – PMTCT – is also in place. Thirty-two voluntary counseling and testing centers (VCT’s) have been built around the country for free and voluntary testing – a critical foundation and entry point for other HIV/AIDS response programs. All these initiatives form part of the overall strategy for prevention, treatment, care and support – the cornerstones of Botswana’s national response to HIV and AIDS,” President Mogae said.
He repeatedly stressed that Botswana’s efforts against HIV/AIDS wouldn’t have much chance of success without PEPFAR – no matter the criticism directed at the Plan by activists who say its emphasis on abstinence and being faithful as key infection prevention methods is unrealistic.
“The quantum of resources under PEPFAR – a significant amount from a single source by any standard – has helped translate national consensus into tangible opportunity for millions around the world,” Mr. Mogae said.
PEPFAR, he added, had given “renewed hope” to millions in sub-Saharan Africa.
“The commitment of the American people and their government to fight HIV/AIDS is beyond doubt, in this instance. PEPFAR is now a critical partner in the historic and heroic battle to save lives. PEPFAR has turned despair into hope. PEPFAR has galvanized donor countries and agencies alike to act in concert in the interests of humanity,” President Mogae told a crowd in Washington.
He said what Botswana had achieved in terms of care and treatment was “only phase one” and that prevention of new infections remained the country’s “ultimate” objective.
“That’s why we said we wanted zero infections by 2016. We are under no delusion that we are overcoming the epidemic. We agree…. that the decline (in HIV prevalence) from 37.4 percent to 32 is marginal – only 5.2 percentage points.”
Mr. Mogae said that most of the international assistance Botswana was now receiving it was channeling into prevention messages.
“We are producing plays, videos, addressing meetings, holding seminars, we are inviting people to come up with ideas of what else can done - pursuant to prevention, rather than treatment…. Beyond that, I don’t have any other magic wand to wave. But I am thinking….” he mused.
But President Mogae was aware that his country still faced grave challenges in its anti-AIDS efforts. One of these, he said, was overcoming reluctance amongst Botswana’s media to report in a “helpful way” on the pandemic, and to assist the government with disseminating important information about the disease amongst the public.