Prof Sheila Tlou, M.P, Former Minister of Health, Botswana

Abstract

Coping with HIV and AIDS in Resource-Constrained Settings: The Case of Botswana

This presentation shares the successes, challenges, and the lessons learned in interventions against HIV and AIDS, especially in the face of financial and health human resource constraints.

Botswana is described as an example of a country whose gains in Primary Health Care were completely reversed by the HIV/AIDS epidemic. When the AIDS impact peaked in the 1990’s, infant mortality rate had doubled and life expectancy was cut by 20 years. From the initial reaction of denial, the political leadership became proactive and mobilised for a multi-sectoral response. Health care was prioritised and the health budget was doubled to be 22% of the overall budget. The emphasis was on evidence-based practice and its effect on interventions to halt the spread of HIV and to ensure an HIV free generation by 2016. National programs include HIV prevention, Prevention of Mother to Child Transmission (PMTCT) with coverage of over 90%, provision of ARV’s to over 90% of eligible patients, home-based care, and care of orphans and vulnerable children. In all these, the emphasis is on research and proper monitoring and evaluation.