Former President Festus Mogae says Ministers and MPS are not doing enough in the fight against AIDS. He shared his views on cost-sharing in the provision of antiretroviral drugs and his scepticism regarding America’s latest interventions in the fight against HIV/AIDS with EDGAR TSIMANE
Sunday Standard: What needs to be done to turn the tide against AIDS in Botswana?
Festus Mogae: We should all be involved. My fear is that a lot of the people experienced the trauma that we went through by the time I became President at the peak of the AIDS. We were burying 18 to 25 people in every one of our villages every weekend. We have stabilized the situation. AIDS is no longer the death sentence that it used to be. The shock effect of those days has passed; the dead are being forgotten. We had cases when patients would be sleeping on the floor and on tables and everywhere. This is when we started home-based care to reduce the number of patients lying on the floor. The Doctors and the nurses were suffering from mental stress.
SS: Are authorities presently doing enough to fight HIVAIDS?
FM: Members of Parliament and Ministers don’t talk about AIDS anymore but it is still there. We are not out of the woods. I wish the authorities could still be warning us and not leaving the fight against AIDS to Naca [National Aids Coordination Agency].
SS: What are your views on cost sharing in the provision of retroviral drugs?
FM: Other things being equal, it may be necessary. It may be unavoidable if there are many people who need treatment. It would be better to have people contribute towards the cost of anti-retroviral drugs. The difficult choice is if you have 100 people in need of treatment but you only have money for 60 people. What do you do? Do you give the 60 people 100% of that money and zero to the 40 people? That is the kind of the dilemma you face. But that, of course, is assuming the government is honest.
On the face of it, it is risk regrettable. There are people who cannot afford antiretroviral treatment. If there has to be contribution then you must have some kind of way of determining those who need assistance. It is not something which should be rushed into. The government ought to come out and be fair and frank with people and say this is what we are spending on and these are the resources at our disposal.
SS: The International Monetary Fund (IMF) encourages governments to cut on spending, including social spending. There are fears this could negatively impact on AIDS budgets. What is your view?
FM: Well, it is always debatable. Some people will say it is a question of priorities. People say African governments can get rid of their useless armies which can’t defend their countries but the only thing they are good at is overthrow their own governments. This is what the IMF will tell you. The IMF will tell you that the money could go to agriculture, education and health. So on the face of it, it is a conflicting message.
SS: Are the new interventions by the American government to scale up existing HIV/AIDS interventions, something Africa should embrace?
FM: The Americans are not as generous as they sound. What they are saying is that they are pulling out of Africa because they don’t have as much money as before. They are saying to African governments you must spend more of your money. That is what Secretary [Hillary] Clinton has said. But she put it in a clever way as if they are increasing assistance. Americans are focusing on policy. They are checking out but they sound as if they are coming in.
SS: Are we making progress in the fight against the scourge?
FM: Complacency has set in. People feel it’s passed and gone. Unfortunately also, we still have stigma. I don’t know what can be done to make people realize that AIDS is still there. It is a quiet killer. The moment we relax our guts before we know it AIDS will be killing many of our people as it did the last time maybe not as dramatically as before because people now have access to antiretroviral drugs but it would have been much better if there was no stigma and discrimination. Everybody must be tested and treated. I don’t even say people must come out. Personally, I never subscribed to the advertisement: “Come out and break the silence”. It reminded me of a movie series in the 70s called the Fugitives where the police are always saying come out hand yourself in. I have always felt that was stigmatizing. What I wish is that we could kill stigma and let AIDS be an ordinary disease. We now know we can leave another 30 years or even more if we take treatment. And the knowledge we know is that the earlier you can start [on retroviral treatment] the better.
