The Global Fund to fight AIDS and Tuberculosis and Malaria has expressed both hope and despair in Botswana Government’s commitment to remove human rights-related barriers to HIV and TB.
The international donor organisation, whose grants have helped scores of Batswana to access antiretroviral therapy and improve access to voluntary HIV testing and counselling programs, expressed its displeasure in its mid-term assessment of Botswana report.
The Global Fund report observed that: “Although Botswana government stakeholders appear to be supportive of programs to remove human rights-related barriers to HIV and TB, key informants described a lack of institutional drive across all relevant government sectors and a corresponding lack of political will or engagement for implementation from the most senior government ministries.”
The report says this is consistent with the findings of the 2018 baseline assessment, which described a lack of strong leadership on the part of government stakeholders to address and remove barriers, even within the Ministry of Health and Wellness, which was reluctant to support key population concerns stating the limitations imposed by current laws.
The report noted that there has been progress on this front, most explicitly with the inclusion of key populations in the NSF III (National Strategic Framework), and recent court victories for LGBTI (Lesbians, gay bi-sexual, trans and intersex people have contributed to a more receptive environment for engagement with government actors.
The report says a Steering Committee within the TWG (Thematic Working Groups), chaired by a representative from the Ministry of Health and Wellness and comprised of government stakeholders who meet periodically to review the implementation of human rights programs, also holds promise in fostering political commitment to and coordination of human rights programming from the highest levels of government.
“Moreover, the establishment of a Health and Human Rights Unit at NAHPA in 2019 and the appointment of a Legal and Human Rights Officer tasked with executing the National Strategic Framework and coordinating Botswana’s multi-sectoral HIV responses has helped drive the work of the TWG and encouraged greater government ownership of the National Plan, which was also launched in coordination with the Office of the Deputy President and included high profile representation across government sectors,” the report says.
Global Fund says housing the Human Rights Unit at the Ministry of Health and Wellness rather than at NAHPA (National Aids and health Promotion Agency).
The report says an array of community organizations representing key populations and civil society have participated in the Breaking Down Barriers initiative, having contributed to and validated the baseline assessment during the multi-stakeholder meeting, implemented programs to reduce human rights-related barriers, and helped develop the National Plan.
It says while organizations that specifically engage in programming to address discrimination against women and gender-based violence or that represent people with disabilities have been less actively involved in the initiative.
On the whole, key informants described how key population-led organizations had become better equipped to engage in human rights programming and to contribute to processes to determine the national HIV and TB response, based on a shared understanding of human rights-related barriers and priority responses.
“At the same time, there is a perception among some key informants that more established organizations that are recipients of Global Fund funding are encouraged to expand, while emerging organizations are not,” the report says.
It says some key informants consequently expressed the need to nurture the growth and sustainability of grassroots, key population-led organizations, and their capacity to engage in human rights programming — thus facilitating the mainstreaming of human rights into a greater diversity of program implementers.
Touching on the donor Landscape, Global Fund says as at the time of the baseline assessment, international donors are the main source of funding of programs to reduce human rights-related barriers to HIV and TB services in Botswana, and key informants consistently described the Global Fund as the main funder for such human rights programs.
“PEPFAR is a major funder of HIV programs in Botswana and projects such as LINKAGES, which provides HIV prevention, care and treatment services for female sex workers and men who have sex with men also integrates human rights concerns into programming,81 while PEPFAR’s Local Capacity Initiative (which concluded in March 2018) supported activities to strengthen the advocacy capacity of local civil society organizations,” the report says.
It says additional but limited funds for HIV-related human rights activities come from ARASA, FHI 360, Frontline AIDS, Open Society Initiative for Southern Africa (OSISA), Red Umbrella Fund, COC Netherlands, UNDP and UNFPA.
“As key informants shared, the funding landscape for human rights programming is extremely competitive. There are scant domestic funds for programs to reduce human rights-related barriers to HIV and TB services, with the majority of domestic health funding allocated to HIV service delivery and clinical interventions,” the report says.
