AIDS in Botswana: a new dawn?

aidsA decade on from the “Masa” campaign, health officials are cautiously optimistic that progress is being in tackling the deadly disease

In 2001, with one in three of its population infected, Botswana’s government took a bold decision to tackle AIDS head on by combining public education and a free national drug-treatment program that was dubbed Masa, the Setswana word for dawn. Commemorating World AIDS Day on December 1, the country had reason to look to the future with hope.

The epidemic is still very much a part of everyday life, but health professionals and researchers say that as a result of the nation’s antiretroviral campaign, estimated to reach 90,000 of the 110,000 in need of treatment they are making progress against the deadly disease, measured by an increase in life expectancy from 40 in 2002 to 50 in 2007.

A large part of the progress is thanks to a research collaboration between the Botswana government called the Botswana-Harvard Partnership. In 2001, the Botswana-Harvard Partnership opened a modern laboratory facility on the grounds of Gaborone’s Princess Marina Hospital where researchers look for answers about HIV’s behaviour and conduct studies about prevention and treatment.

The Masa antiretroviral program marked a turning point in the fight against AIDS in Botswana. Before then, hospitals were unable to treat people who were already seriously ill from the effects of the virus, and the mortality rate was high.

Today, those stricken by the disease have hope. With antiretroviral drugs, people can manage the illness, continue to work, and care for their families. Before the program began, the death toll, and its effect, such as rising numbers of orphans, continued to mount.

And as the certainty of death has lessened, the stigma attached to AIDS has also diminished. Nowadays, people who suspect they have AIDS are more willing to seek care and, once diagnosed, share that information with family and friends.

Recent initiatives have involved tribal elders in rural areas leading by example and publically taking AIDS tests, for example.

Botswana was the first African test case in trying to treat large numbers of patients. Its success will buttress the argument for greatly expanded treatment efforts in the rest of Africa and other developing regions. The Joint UN Program on HIV/AIDS (UNAIDS) has long maintained that both prevention and treatment are necessary in the campaign against AIDS, although up until Botswana led the way, fewer than 30,000 of the almost 29 million Africans infected with the virus have access to the ARV drugs that have dramatically reduced death rates in rich countries.

Written by Nick Lyne