Ten years ago, in 2003, the world was in the midst of an AIDS pandemic and Africa was the epicenter. Nearly 30 million people were infected with the AIDS virus, including 3 million children, and more than 8,000 people were dying from it every day. In Africa, AIDS was wiping out an entire generation. The American people saw the need to respond through the creation of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), our government’s initiative to support partner nations around the world in responding to HIV and AIDS. PEPFAR is the largest commitment by any nation in history to combat a single disease internationally, and since its inception, Botswana has received more than $700 million from the U.S. government to fight HIV and AIDS.
In its early years, PEPFAR faced a daunting task. In many countries, healthcare systems were overwhelmed by the disease. The unparalleled mobilization of resources, both human and financial, strengthened healthcare systems and with the introduction of anti-retroviral (ARV) treatment, millions of people who would have died just a few months prior to PEPFAR’s inception not only survived ÔÇô they got better.
We recognize the incredible foresight and leadership shown since the very beginning by the government of Botswana, which made a commitment in 2002 to make treatment available to its people before PEPFAR was even conceived. Botswana’s global leadership on this issue was part of the movement that mobilized the remarkable generosity and ambition of the American people, and a very fruitful partnership was formed.
What a difference a decade has made! Today, the U.S. government supports more than five million people on ARV treatment. Globally, new HIV infections have declined nearly 33 percent over the past decade, and AIDS-related deaths have decreased by 30 percent. U.S.-supported programs have saved one million babies from being born with HIV. Today there are 13 countries in the world that are at the programmatic tipping point in their AIDS epidemic ÔÇô the point where the annual increase in adults on treatment is greater than the number of annual new adult HIV infections. Botswana is one of them.
Consider Botswana’s progress: The number of people on ARV treatment has grown from a handful of individuals in 2002, to more than 95 percent of eligible people today. Mother-to-child transmission of HIV has been reduced to less than four percent, from levels of 30 to 40 percent only a decade ago. The rate of adults in Botswana who know their HIV status through routine and voluntary testing and counseling is more than 55 percent ÔÇô one of the highest rates in the world. Botswana has made remarkable progress due to the outstanding work and leadership of the government of Botswana, and we are proud to have supported these outcomes.
These are not just statistics. They represent lives saved, and renewed hope for families and communities country-wide: individuals like Balekanye Mosweu, a Francistown mother who discovered in 2006 that she was both HIV positive and pregnant with twins. She enrolled in Botswana’s Prevention of Mother-To-Child Transmission (PMTCT) program and was one of the first women in the country to benefit from early infant testing. Her twins, Thata and Thatayaone, are now 7 years old, healthy and HIV-negative; they represent the promise of a hopeful future: that of an AIDS-free generation.
The PEPFAR Blueprint, released on World AIDS Day in 2012, reflects lessons learned from almost 10 years of experience in supporting countries to rapidly scale-up HIV prevention, treatment and care services. It outlines the opportunity for the world to move towards an AIDS-free generation, and underscores that the United States’ commitment to this goal will remain strong, comprehensive and driven by science. It clearly outlines how PEPFAR is helping ÔÇô and will continue to help ÔÇô to make an AIDS-free generation a reality globally and in Botswana.
Our success so far gives cause for great optimism, but the job is far from finished. According to UNAIDS, an estimated 1.7 million people die annually from AIDS-related causes. Here, in Botswana, about 24% of the adult population is HIV-infected, with about 12,000 new infections annually. The difficult global economic outlook is squeezing global health and development resources. However, the opportunity before us is extraordinary, and we must seize it. We can achieve lasting victory in the fight against HIV/AIDS. To do so, we need the continued commitment and leadership of partner countries, reinforced with support from donor nations, civil society, people living with HIV, faith-based organizations, the private sector, foundations, and multilateral institutions.
Just last month, I was proud to announce a powerful collaboration between the United States, the Botswana Ministry of Health, and Harvard University on a $64 million project with the aim of drastically reducing new HIV infections through a method called “combination prevention.” The four-year project, called Ya Tsie (derived from the Setswana proverb meaning “Teamwork bears more fruit than individual effort”) is already underway. Its aim is to determine whether coordinated and strengthened community-based HIV prevention methods prevent the spread of the virus more effectively than the standard methods that are offered individually today. We expect big things from Ya-Tsie and consider it the most important thing the United States will do in the next decade to help defeat the HIV/AIDS pandemic.
December 1 is World AIDS Day, a time when the global community reflects on the lives lost, and those forever changed, as a result of AIDS. It is also an opportunity for us to celebrate lives saved, and recommit to the continued fight against AIDS. Millions of people are now living healthy, productive, and dynamic lives thanks to strong partnerships. Today, with the Government of Botswana, we can forge an AIDS-free future for an entire generation. Balekanye’s seven year-old, HIV-free twins Thata and Thatayaone are all the proof you need that it is indeed possible.
Michelle D. Gavin is the Ambassador of the United States of America to Botswana
