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| Botswana |
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Country Situation Analysis
UN Support to the National Response
Contacts
UNAIDS Global Report 2006 Data |
Botswana has a multisectoral response to the HIV epidemic and effective coordination is critical to the country's enhanced collective response.
The National AIDS Council, chaired by His Excellency the President of Botswana is the highest HIV/AIDS policy and decision-making body embracing representatives from all sectors except donors. The National AIDS Coordinating Agency is its secretariat and its mandate covers the coordination of policy development, implementation of HIV programmes by various stakeholders, monitoring and evaluation of the national response and resource mobilization.
Botswana's classification as an upper middle-income country saw a gradual decline in foreign donor support with USA Centers for Disease Control and Prevention/Botswana/USA/African Comprehensive HIV/AIDS Partnerships, and UN being among the remaining donors. As a result, the government contributes over 80% of the HIV budget and is experiencing a financial strain. Consequently, Botswana is in the process of seeking increased support by appealing for the return of previous donors.
The secretariat coordinates donors through various mechanisms like the Country Coordinating Mechanism, Development Partners Forum and the Botswana HIV Partnership Forum. However, existing donor overlaps and gaps need to be further streamlined.
Women and young people are among the most vulnerable groups in the country.
In response, programmes specifically designed to meet the needs and represent the voice of women have been established. National programmes addressing mother-to- child transmission of HIV continue to provide treatment, care and support.
HIV prevalence among teens in Botswana is showing signs of decline but youth- targeted initiatives focusing on education, behaviour change, and stigma reduction still need to be fully integrated into the planning and review of progress and processes of the national strategies and policies. In addition, the situation of marginalized groups like men who have sex with men and sex workers needs to be further addressed.
Botswana continues to strive to overcome barriers such as treatment costs, weak monitoring and evaluation capacity and inadequate human resources. Moreover, intangible challenges embedded in socialcultural beliefs, include gender inequality and social issues, HIV-related discrimination, and stigma. Efforts to overcome these barriers include: national stakeholders' forums; consultative meetings to identify actionable ideas; and increased government financial investment in national initiatives and programmes. Nationwide multisectoral efforts target education and empowerment of the people of Botswana concerning the very real and pressing issues surrounding HIV.
Challenges
- scaling up towards universal access, especially in the area of prevention;
- lack of skilled human resources is a major challenge to the scale up towards universal access;
- assessing the impact of increased antiretroviral rollout, increasing the work on prevention with positives looking at issues like accessibility, adherence, nutrition and stigma and proper resistance monitoring is also an important component
- organization and management assessment of the secretariat;
- monitoring and evaluation capacity is still limited; and
- sociocultural beliefs, women's position in society, discrimination and stigma remain complicated obstacles to surmount through innovative and collective programming.
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Cosponsor involvement
The UN response to HIV/AIDS in Botswana is in line with the National Strategic Framework goals and the Common Country Assessment/UN Development Assistance Framework objectives. In 2005, UNDP Implemented the Botswana Leadership Rollout Strategy with a district workshop in September. The responsibility to undertake sentinel surveillance was shifted back to the Ministry of Health and WHO provided sentinel surveillance training to Ministry of Health officials in partnership with CDC/BOTUSA and UNAIDS. WHO also assisted in organizational restructuring which led to the establishment of the Department of AIDS Prevention, Treatment, Care and Support and Department of Public Health. UNFPA and UNICEF conducted their Mid Term Review in 2005. In addition, UNICEF reactivated its involvement in paediatric HIV care and signed an agreement with Baylor Children's Clinical Centre of Excellence and Ministry of Health to scale up capacity building for paediatric HIV care and treatment.
UNFPA continued to support youth participation in HIV activities. They also supported programmes to promote male involvement in HIV activities.
UNHCR was able to secure funds for provision of antiretrovirals for refugees starting in 2006.
Plans and objectives for 2006
- UNDP: Leadership, community capacity enhancement, operational research (Macroeconomic Impact study and Demographic Impact study); mainstreaming HIV and gender;
- UNICEF: Early childhood life skills development, paediatric HIV care and treatment, prevention of mother-to-child transmission, adolescent sexual and reproductive health, orphans and vulnerable children. A key activity in 2006 is the Unite for Children, Unite against AIDS Campaign;
- WHO: Support the health sector response including sentinel surveillance, quality access to treatment and care assessment, syndromic management of sexually transmitted infections, universal access to prevention, treatment, care and support among others;
- UNFPA: Youth and HIV, male involvement in HIV programmes;
- UNHCR: Provision of treatment for refugees.
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Viola Morgan
Chair, UN Theme Group on HIV/AIDS
Deputy Resident Representative
(UNDP)
Tel: 267 395 2121 ext 204
Direct line: +267 391 3193
Fax: +267 390 1459
Email: viola.morgan@undp.org
Evaristo Marowa
UNAIDS Country Coordinator
Tel: +267 395 21 21
Fax: +267 393 1243
Postal Address: UNAIDS
P.O. Box 54
Gaborone, Botswana
Email: marowae@unaids.org
National Coordinator
Chris Molomo
NACA
Private bag 00463
Gaborone, Botswana
Email: cmolomo@gov.bw
Networks of Organisations working on HIV
BONASO
Daniel Motsatsing
Agency Director
P.O. Box 3129
Gaborone, Botswana
Email: bonaso@botsnet.bw
BONELA
Christine Stegling
Agency Director
P.O. Box 402958
Gaborone, Botswana
Email: bonela@botsnet.bw
Networks of people living with HIV
BONEPWA
Agency Director
David Ngele
P.O. Box 1599
Mogoditshane, Botswana
Email: bonepwa@botsnet.bw
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I. DEMOGRAPHIC, SOCIAL AND ECONOMIC INDICATORS |
Estimated Population (thousands) |
1765 |
Population Growth Rate |
0.1% |
Life expectancy at birth |
Men |
Women |
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40 |
40 |
Human Poverty Index |
Rank |
Value |
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94 |
48.4 |
Human Development Index |
131 |
Percentage of people living with less than US$2 |
50.1% |
Per Capita Gross National Income |
US$ 8920 |
Per Capita Government Expenditure on health |
218 |
II. HIV AND AIDS ESTIMATES |
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Number of people living with HIV |
270 000 [260 000 – 350 000] |
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Adults aged 15 to 49 HIV prevalence rate |
24.1 [23.0 – 32.0]% |
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Adults aged 15 and up living with HIV |
260 000 [250 000 – 330 000] |
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Women aged 15 and up living with HIV |
140 000 [130 000 – 190 000] |
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Deaths due to AIDS |
18 000 [17 000 – 25 000] |
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GENERALISED EPIDEMICS |
Children aged 0 to 14 living with HIV |
14 000 [6100 – 32 000] |
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Orphans aged 0 to 17 due to AIDS |
120 000 [110 000 – 150 000] |
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III. COUNTRY PROGRESS INDICATORS |
GENERALISED EPIDEMICS |
Expenditures |
National funds spent by governments for domestic sources |
US$ 165 000 000 |
National Programmes |
Percentage of pregnant women receiving treatment to reduce mother-to-child transmission |
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Percentage of HIV-infected women and men receiving antiretroviral therapy |
85% |
School attendance among orphans |
92% |
non-orphans |
93% |
Knowledge and Behaviour |
Percentage of young people aged 15 to 24 who currently identify ways to prevent HIV |
Men |
Women |
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33% |
40% |
Percentage of young people aged 15 to 24 who had sex with casual partner in the past 12 months |
Men |
Women |
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N/A |
N/A |
Percentage of young people aged 15 to 24 who had sex before 15 |
Men |
Women |
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N/A |
N/A |
Percentage of young people aged 15 to 24 who used a condom last time they had sex with a casual partner |
Men |
Women |
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88.0% |
75.0% |
CONCENTRATED/LOW PREVALENCE EPIDEMICS |
Expenditures |
National funds spent by governments for domestic sources |
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Policy Development and Implementation Status |
Policy information, education, communication and prevention for most-at-risk populations |
Yes |
Policy to expand access to essential preventive commodities among most-at-risk populations |
Yes |
National Programmes |
Percentage of HIV-infected women and men receiving antiretroviral therapy |
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Percentage of most-at-risk populations reached by prevention programmes |
Men who have sex with men |
Sex workers |
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N/A |
N/A |
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For more information please contact Richard Delate at tel. +27 11 517 1524, mobile +27 82 909 2638 or visit www.unaids.org.
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Country profiles provide key information on the status-quo of the HIV pandemic in the countries of the region. Data is updated by the UNAIDS Country Offices on a yearly basis.
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