Botswana is on the cusp of epidemic control - US

- HIV epidemic, an equal opportunity employer - Cloud

The outgoing US Ambassador to Botswana, Craig Cloud has exulted Botswana’s management of both the HIV/Aids and Covid 19 scourges, proclaiming that the country is “on the cusp of epidemic control.”

At a roundtable discussion he held with the local press corps in Gaborone, Ambassador Cloud stated that the strides that Botswana has made with the help of the US government in the health sector since he arrived in the country in 2019, “have been amazing.”

To sample a few of the strides, he picked the Silver Tier Status – a World Health Organisation rating - that Botswana celebrated at last year’s World Aids Day commemoration for having surpassed the less than five (5) percent of mother to child transmissions.

Cloud exclaimed in delight, that Botswana is not only below 5 percent it is at 0.56 percent, which means that about one (1) in 200 children either contract HIV during the birth process or after they are born.

He said this figure contrasts sharply with the 20 percent or 20 children out of 100 that were contracting HIV during birth 19 years ago in 2003!

“That is a huge market success,” Cloud said, adding that it is also emblematic of the cooperation between the US government and the government of Botswana, the United Nations, and other international donor organisations considering that it is the Non-Governmental Organisations on the ground that are actually doing the work.

“To me that is striking – one in 200 babies now versus 20 out of a hundred babies just nineteen years ago!” the US envoy remarked.

Cloud said that the preliminary results of a study they have conducted to figure out exactly what the pandemic is doing right now in Botswana show that 93 percent of the people know their status; 98 percent of the people who know their status are on ARVs and 98 percent of people who are on ARVs are immuno-suppressed which means that they cannot transmit the disease.

“Botswana is on the cusp of epidemic control and that has allowed us to change the way that we are going to be doing our PEPFAR programme going forward,' he said.

Cloud explained that In the past, their flagship HIV/Aids programme - the United States President's Emergency Plan For AIDS Relief (PEPFAR) – had operated through direct service delivery, whereby they had people on the ground that they were paying to see patients; administer medicines and other chores.

“We are changing that and as we move forward, we are pivoting from direct service delivery to technical assistance, which means that we will be providing expertise in how to do things, what data is important and stuff like that, but it is going to be the government of Botswana that actually does the work and we are going to be backing away from that.”

He reiterated that they are doing this in concert with the government because the last thing “we want to do is to see the gains that we have made slipping away!”

Cloud hailed as “super exciting” the 2020 decision by the government of Botswana to start giving free ARV to non-citizens as well.

He said that was super important because the HIV epidemic does not care what your passport says or who you sleep with,” it is an equal opportunity employer if you will,' as it will attack you regardless of your race, ethnicity, or what border you cross!

The Ambassador, whose next assignment will be in Eritrea, said that all of these things that they have been working on with the government have been exciting and was so impressed with the cooperation – not just with the government of Botswana - but with the entire international community and the local NGOs too!

“When I arrived in 2019, only six (6) percent of USAID implementing partners – the ones that we give money to, to do the work – were indigenous organisations, but right now 62 percent of USAID implementing partners are Batswana,” he said with a measure of contentment.

“This is also super important because if it is international donors that are doing the work, first it is a lot more expensive and second, it is not going to be sustainable. So, we are really trying to localise everything that we are doing!”

Cloud assured that the US government is not going to leave Botswana, saying they are only shifting their responsibilities in order to keep making progress.

As for Covid response, he said that Botswana is listed as the third most-vaccinated country in Africa, but that he considers Botswana the first most-vaccinated country in Africa because the other two countries – Mauritius and Seychelles – “really aren’t part of the continent, they are little islands with a couple hundred of thousands of people that is easy to vaccinate!”

Cloud said that Botswana has done a great job of rolling out the vaccine and took pride in the part that the US assistance played in demand generation and things like that, which is evidenced by the fact that unlike a lot of other countries, Botswana has not really suffered from vaccine hesitancy. He said this has resulted in a much better survival rate, a much lower infection rate, and better outcomes for the people because most of them are vaccinated.

He said that the US has built 14 isolation clinics across Botswana; donated 182 000 Pfizer vaccines, as well as helped with the supply chain to ensure that the vaccine is distributed where it is needed.