Mr Chairman,
The efforts of the Government of Botswana to fight HIV/AIDS are well known to most of us around this table. These efforts are led by none other than President Mr Festus G. Mogae, who mobilized not only his countrymen and women, but also the broad international community in the face of calamity. For President Mogae and the people of Botswana, HIV/AIDS is not merely a disease, but a threat to the survival of a whole people.

The measures employed are indicative of the seriousness with which the threat is perceived. The strategy, based on three tenets, namely prevention, treatment and care, sought to direct the attack to areas where the virus had done the most damage. To date, the Government has committed over USD$70 million of its own resources in expenditure directly related to HIV/AIDS.

For the national planning cycle between 2004 to 2009, known as National Development Plan 9, USD$366 million has been earmarked to deal with the crisis. This however is not enough. The total estimated cost for the plan period is over USD$2 billion. The Government has also completed a National Strategic Framework for HIV/AIDS for 2003 – 2009, which outlines the priorities, goals, objectives and challenges of the National Response.

In keeping with the Government’s strategy to make HIV/AIDS an integral part of national planning and budgeting, the Strategic Framework has been aligned with National Development Plan 9 referred to above, which is the overall national planning strategy, for the country between 2003 and 2009. The partnerships forged with the US government, the US private sector (some of whom are present here today), the European Union, European countries, and the UN agencies, speak for a concerted effort, indeed an unprecedented one, to galvanize the international community, to lend a helping hand in the fight for survival. Free anti-retroviral therapy was another such unprecedented step.

The introduction of Routine Testing for HIV in January 2004 is a measure aimed at enhancing the effectiveness of existing mechanisms and health infrastructure in fighting the pandemic. It should therefore be seen as a “value – adding” step in a continuum of measures for efficacy and effectiveness, and not an independent or isolated measure. Specifically it is an incremental step to voluntary counseling and testing.

Definition: Routine testing has been described as a situation where HIV testing is treated as normal, rather than exceptional. It is not mandatory or forced on patients, and is still accompanied by counseling. Test results are made available to the patient within a few minutes.

Legibility: The following are categories of people who qualify for routine testing:

- All pregnant women;
- All patients with symptoms suggestive of an AIDS defining illness;
- Any patient presenting a sexually transmitted infection;
- Any individual who comes for a general medical examination; and
- Any individual who requests to be tested.

Public response: Reports from medical institutions indicate an overwhelming positive response from the target sample. Over 90% of those offered a routine test have accepted, representing a higher rate than that for voluntary testing which stands at 76%. The political leadership is not only behind the measure, but is also in the forefront advocating for it.

The initiative also enjoys the support of civil society once it became clear that routine testing would be done with full consent of the individual concerned. Most hospitals are implementing the programme as they now have the guidelines for who should be tested.

Benefits: Over time, as the programme continues, a clearer picture of the benefits will emerge and be evaluated. However, presently the initiative is contributing to reducing stigma which was a major cause of resistance to voluntary testing. And with more patients being tested, it means earlier diagnosis and treatment, and ultimately lower mortality rate.

Challenges
- More financial and manpower resources will be required to cater for an increased number of patients;
- Expansion of medical facilities to accommodate more patients;
- Training of more medical personnel;
- In the long-term, the cost of drugs is a factor, as it would determine how many people can be put on therapy.

The people of Botswana have taken and continue to take bold and innovative measures to fight HIV/AIDS. These initiatives are taken in good faith to address legitimate needs in trying times. For this task, Botswana needs, more than ever, international collaboration and understanding, to refine these tools where necessary, to enhance their capacity to deliver on the core mandate, namely saving human life.

I thank you.