Brazzaville, 25 October 2004 -- Botswana is recording steady progress in providing antiretroviral therapy (ART) to people living with HIV/AIDS (PLWA) in the country and this has considerably reduced the overall mortality of patients, according to a report in the current issue of the Communicable Diseases Bulletin a monthly publication of the WHO Regional Office for Africa (AFRO).

"The overall mortality of patients on (antiretroviral) treatment (in Botswana) is less than 10%", says the report which adds: "The Botswana experience proves that it is possible to provide ART services on a wide scale, with good results, in resource-limited settings."

The report was compiled by experts from AFRO, the Ministry of Health of Botswana and the Botswana WHO Country Office.

Botswana, with a population of 1.7 million, has one of the world's highest HIV prevalence rates (37,4%), with 110,000 of an estimated 330,000 PLWA needing retroviral treatment. The epidemic has played a major role in reducing life expectancy in the Southern African country from 67 years to 57 years in just ten years, and has also contributed to the increased number of Batswana orphans, now estimated at 60,000.

In collaboration with international and local partners and other stakeholders, the government of Botswana began providing ART services in January 2002 from a referral hospital in Gaborone, the capital, and within six months three other hospitals agreed to provide the same services.

By June 2004, 16 sites (government hospitals) were actively providing ART to 17,387 patients while private sector health facilities were delivering ART to 6,700 patients. As a result, 24,087 patients had been placed on treatment 29 months after the initiation of the programme. …/2 The first-line regimen used by the country is a fixed combination of Zidovudine and Lamivudine in one tablet (Combivir) and nevirapine or efavirenz tablet.

The authors of the report found that follow-up of patients had been reasonably good at 90%, the adherence rate also good at more than 85% in government facilities, but ranging from 72% to 80% among patients in private sector health facilities. In districts where health facilities and PLWA support groups collaborated, adherence was more than 95%.

The report, however, states that long waiting time in government facilities remained a challenge. This is attributable to the inadequate number of physicians to evaluate patients to initiate treatment, the small number of counselors to provide services and the limited space for conducting counseling sessions.

It warns that if this trend continued, the number of patients waiting to begin treatment will have surpassed those on treatment by March 2005. It is hoped, however, that the planned countrywide ART rollout programme for 2004 will avert this trend.

On prospects for the future, the Bulletin says that the country's ART programme implementation plan in the context of the present emergency include scaling up treatment to ensure that Botswana's 32 government hospitals provide ATR services before the end of 2004, and including some clinics in the initiation of ART in 2005.

For further information: 

Media contact:

Samuel T. Ajibola 

E-mail: ajibolas [at] afro.who.int 

Tel:+ 47 241 39378; Fax: + 47 241 39513