What Botswana Can Teach Us about Eliminating Pediatric HIV/AIDS
Dr. Richard Marlink
New York, New York
September 24, 2010
I had the opportunity this week to participate in a panel discussion hosted by the Global Health Council
at the United Nations
as part of the special summit on the Millennium Development Goals
In the words of my fellow panelist, the Minister of Environment and International Development from Norway, this particular session was organized to celebrate and learn from the success story of Botswana. Botswana has been at the forefront in Africa in its response to the HIV/AIDS pandemic, particularly in preventing mother-to-child transmission (PMTCT) of the virus. Other panelists included the Vice President of Botswana, His Honor Mompati Merafhe, Michel Sidibé, Executive Director of UNAIDS
, and representatives from UNICEF
and the United Nations Population Fund
– all discussing the way forward in the context of lessons learned from Botswana.
Dr. Marlink is interviewed by Global Health TV
following his panel session at the MDG Summit.
(Photo: Global Health Council)
Representing the Elizabeth Glaser Pediatric AIDS Foundation, the main point that I was asked to address was: “Is the elimination of pediatric AIDS possible?”
Obviously, I was happy to address that question with a clear answer: Yes!
The details of how Botswana was able to scale up its own PMTCT programs present a road map to do just that– and one which other countries can replicate.
The Vice President of Botswana, who chairs the country’s National AIDS Council, outlined their approach to integrating HIV prevention and treatment services within the overall healthcare system, combining them with maternal and child health and other efforts. As a result, the fight against AIDS has actually helped expand, integrate, and decentralize all health services throughout Botswana.
In fact, Botswana’s approach tracks precisely with the three strategic areas the Foundation also pursues to stop the spread of HIV in children: research
, advocacy and policy change
, and program implementation
in an integrated fashion.
Botswana has relied on research and new findings, especially in the world of PMTCT, to guide its own policy changes to dramatically reduce mother-to-child transmission. The Vice President and other panelists detailed some of the most effective changes, such as:
- Creating a national policy of opt-out HIV testing;
- Task-sharing, where nurses can dispense or prescribe HIV medication; and
- Creating a cadre of “lay counselors” who integrate care and address patient and family concerns, regardless of whether they are HIV-related or not.
Botswana has also expanded its Early Infant Diagnosis program, so that infants exposed to HIV can receive a solid diagnosis very early in life, and get rapid access to life-saving treatment if they are HIV-positive. Through integration and decentralization, this is available throughout the country, not just in the capital.
The Foundation is replicating the lessons of Botswana in many countries throughout Africa: facilitating research, advocating for sound, evidence-based health policies, and implementing integrated maternal and child health programs to prevent children from getting HIV infection.
Our ultimate goal is the elimination of pediatric HIV and AIDS worldwide. Working together and learning from countries like Botswana, we can achieve it.
Dr. Richard Marlink is the Foundation’s Senior Advisor for Medical and Scientific Affairs, and is also a professor at the Harvard School of Public Health. He participates in a number of Botswana clinical studies, and is the principal investigator of Botswana's first large-scale antiretroviral treatment study. To view Dr. Marlink's interview on the Global Health TV website, click here.