IRIN/AllAfrica.com Examines Antiretroviral Drug Treatment Adherence in BotswanaIRIN/AllAfrica.com on Wednesday examined how the preservation of HIV/AIDS prevention and treatment programs in Botswana largely depends on preventing the development of the widespread resistance to antiretrovirals that could jeopardize long-term drug affordability. Botswana in 2002 was the first country in Africa to launch a nationwide antiretroviral treatment program and now serves as a "test case" for other African countries, according to IRIN/AllAfrica.com. Some initial concerns associated with the program included whether people living in resource-poor areas of the country would understand the importance of adhering to complex treatment regimens, IRIN/AllAfrica.com reports. According to preliminary data from a study by researchers at Botswana Harvard School of Public Health AIDS Initiative, there is little evidence that people in Botswana become less compliant about taking antiretroviral drugs over time, and program participants have similar or better treatment adherence rates as HIV-positive people living in Western nations, according to researchers. In addition, the Infectious Diseases Care Clinic at Princess Marina Hospital in Gaborone, Botswana, runs an ongoing study that monitors and oversees HIV-positive people with treatment failure. According to data from the study, 4% of the clinic's 14,000 patients have had to be switched to second- or third-line regimens. Medecins Sans Frontieres Australia has warned that drug companies must begin fast-tracking low-cost, second-line drugs to HIV-positive people in Africa to prevent widespread resistance to first-line treatment. The government of Botswana is releasing national guidelines to regulate first-line antiretroviral treatment that will include training in how to identify viral loads. According to Ava Avalos, who is part of the IDCC team, the "biggest challenge" will be monitoring drug resistance in African nations that do not have funding to perform frequent viral load tests (IRIN/AllAfrica.com, 6/13).
More Health Workers Needed
Botswana President Festus Mogae last week said that about 1,900 more health care workers of various professions will be needed from 2003 to 2009 to support the country's antiretroviral drug treatment services, The Voice/AllAfrica.com reports. Mogae said the personnel would include 215 physicians, 150 pharmacists, 50 laboratory scientists, 40 radiographers and 65 nutritionists. According to Mogae, although the country is attempting to reach these personnel targets through training, Botswana still faces challenges in recruiting and retaining health care workers. "In this context, continued investment in training in the health sector is critical if we are to meet both the current and future demands, for sustainability in the long term," Mogae said. He added that the possible expansion of the country's HIV/AIDS programs requires additional resources, particularly in the health care sector, to reach universal treatment targets (The Voice/AllAfrica.com, 6/13).