The northern parts of Botswana, which have some of the highest HIV-AIDS prevalence rates, had their hand strengthened in the fight against HIV-AIDS last week when the US government handed over a state of the art HIV reference laboratory, funded by the US government through their BOTUSA and US President’s Emergency Plan for AIDS Relief Programs.
The Francistown laboratory started operating in May 2003, analyzing samples from the Francistown reference site. The initial workload received during that month was 85 CD4 and 39 viral load samples. To date, the lab has been receiving around 5000 CD4 and 5000 viral load samples per month from various locations in the northern parts of Botswana.
“This increase is testimony not only to the magnitude of the HIV problem but also to government’s response to meet the challenge,” said the Minister of Health, Professor Sheila Tlou, who officially opened the lab.
Tlou also said that with the assistance of BOTUSA, they will be able to meet the high costs of maintaining such a high profile facility. She, however, called on the workers to use the equipment availed to them with diligence and the utmost care so as to increase sustainability.
The minister said that it was heartening to observe that the rate of HIV prevalence among the 19 to 24 group had declined significantly and that the MASA ARV program had made significant improvements in the lives of Batswana.
According to a joint report by UNDP and NACA on the economic impact of HIV-AIDS in Botswana, in the absence of antiretroviral therapy, the impact of HIV-AIDS on GDP would be comparable to the impact that would result from the decline and closure of Botswana’s mining sector over 15 years. But even with the provision of ARV’s, it is still expected that over the 20-year period between 2001 and 2021, the economy of the country will accumulate a 23 percent growth reduction compared to a “no AIDS scenario”.
Prior to the MASA ARV program, local hospitals were overwhelmed with terminal AIDS patients while society reeled under the burden of continuous burials and the care of orphans. To date, the program has enrolled over 90 500 patients, over 9000 of which are in Francistown. Tlou said that these patients require close laboratory monitoring and their facilities had to undergo early maturation as requirements for the new level of testing in Francistown could not be met without significant infrastructural expansions.
Unlike the previous lab, which only dealt with CD 4 and viral load tests, the expanded facility will also include hematology chemistry and tests for monitoring ARV toxicity, further improving the logistics of specimen handling and client management.
In addition, the lab will be able to perform DNA PCR for infant diagnosis which, hitherto, was only performed at the Harvard Reference Lab in Gaborone.
Perhaps the most exciting feature of the lab is that it will also support the Early Infant Diagnosis program, which was rolled out in Botswana as part of the PMTCT program. Early Infant Diagnosis, which tests infants for HIV as early as 6 weeks after birth, has showed remarkable results. Studies have revealed that 96 percent of infants born into the PMTCT program are HIV negative which has been a great inspiration, especially to the health workers whose efforts are finally bearing fruit.
The laboratory was renovated at a cost of US $2 million and a further US$200 000 has been provided for its accreditation in order to enable it to function as a fully fledged reference lab.
Speaking at the ceremony, the US Embassy’s Deputy Chief of Staff Charge d’affaires, Phillip Drouin, said that the government of Botswana has provided inspired and commendable leadership as the country is a global leader in the war against AIDS and a model of commitment in the prevention, care and treatment of the disease. As proof of Botswana’s commitment to the fight against AIDS, Drouin said, the country was the first to provide free ARV treatment to its citizens in 2002 and, 5 years into the program, 90 percent of those estimated to need treatment are receiving it.
Drouin said that in the past, the laboratories were overwhelmed by the increasing number of people on ARV treatment while outdated equipment would often break down.
“But today it gives me great pleasure to hand over a new improved reference laboratory on behalf of the US government,” he said, adding that the new lab is the second largest in Botswana and will help the country to double the number of people monitored for HIV AIDS treatment and care.
Drouin also said that the US President ‘s Emergency Plan for AIDS Relief had purchased new equipment that helped decrease the turn around time for viral load and CD 4 counts and will also provide training and hiring of new lab technicians as well as cater for the maintenance costs.