Botswana Goes from ‘Hopeless to Hopeful’ with Arrival of Free AIDS Drugs
In the coming months, the Botswana government will provide "most" of the country's HIV-positive population with antiretroviral drugs through public hospitals and with monetary help from Debswana, a diamond mining joint venture between the government and mining giant De Beers, the New York Times reports. The government, which is planning to distribute the medications through public hospitals in the nation's two largest cities, Gaborone and Francistown, expects to pay $600 per person for one year of anti-AIDS drugs, in a nation where 36% of adults are HIV-positive. Botswanan President Festus Mogae in his national address this year spent almost half of his time speaking about AIDS and has "personally led the crusade to save his people from what he describes as the 'threat of annihilation,'" the Times reports. The "diamond-rich" country is currently "upgrading its health care system, poring through the medical literature and moving forward in an effort to save its most precious industry and its people." The news of access to free medications has "sent hopes soaring" among Botswanans, and HIV testing has risen by 30% as people learned that "a positive result means likely treatment, not certain death." Dr. David Marumo, who estimates that 80% of his patients are HIV-positive, said, "We used to say there is nothing we can do, but we are going from hopeless to hopeful. If you are HIV-positive now, it doesn't mean you are dying. ... Most people now are planning."
Hope Sparkles in the Mining Sector
Debswana, which has pledged to cover 90% of the cost of treatment for its HIV-positive employees, has allocated $5 million for medications this fiscal year. The company discovered in 1999 that more than one-third of its workers between the ages of 24 and 40 were living with the virus after workers agreed to be tested. In addition, the number of sick days taken by workers "surged" to 9,384 in 1999 from 2,032 in 1995 and the number of AIDS-related employee deaths tripled in that time. Under the Debswana plan, workers must be tested and examined by a company-selected physician prior to beginning treatment. The spouses of employees are also covered, although the policy restricting coverage to only one spouse in a society where polygamy is acceptable has generated controversy, as has Debswana's refusal to cover the children of workers at this time. The offer has created concern among company officials that more employees, who "no longer fear dying from AIDS," will stop using condoms and engage in risky sexual behavior again. Doctors also worry that patients will be unable to comply with the complicated regimen of pills and will spread drug-resistant strains of HIV. And some employees worry that the Debswana plan will publicize their disease in a society that "shun[s]" those suspected to be HIV-positive. But Debswana officials say that in time the disease will lose its stigma and more workers will seek testing (Swarns, New York Times, 5/8).