Botswana – The Economist

9 May 2002

AIDS in Southern Africa.
Edited version of a long article on AIDS in Botswana,
Mozambique and South Africa in The Economist

Fighting back

May 9th 2002
From The Economist print edition

In Botswana, the prime minister himself, Festus Mogae, presides over every meeting of the National AIDS Council and expects all other members to be in attendance without fail. Every minister starts every speech with a message about AIDS. A National AIDS Co-ordinating Agency mobilises activity on all fronts. Posters proclaim the virtues of condoms or, better, abstinence. A radio drama in the local language, Setswana, spreads information about the affliction. And so on. The aim is an AIDS-free generation by 2016 and meanwhile, says Mrs Phumaphi, “we will fight the virus with a passion that is relentless.”

The commitment is admirable, and it has already paid off, in at least one sense. Botswana has been chosen as a partner by the Bill and Melinda Gates Foundation and the Merck Company Foundation in what is said to be the biggest public-private partnership in the world; the two foundations are each contributing $50m over five years and Merck is also donating anti-retroviral medicines for the treatment of HIV-infected patients. The American government’s Centres for Disease Control have sent four professionals to help fight the epidemic. Harvard University is providing assistance with the government’s HIV reference laboratory, and other universities and hospitals in Europe and the United States have also pitched in.

What draws these foreign partners to Botswana? They like the strength of the political leadership, they say. They also consider Botswana to be politically stable—it is a multi-party democracy with no history of coups, military rule or war—and it is notably uncorrupt. Oh, yes, one other reason: it has the highest rate of HIV infection in the world.

Why has such an exemplary country as Botswana come to have the highest rate of HIV infection in the world?

Such paradoxes seem to beset every aspect of the AIDS pandemic in southern Africa. Why should such an exemplary country have an adult prevalence rate of 38.5%? One answer, apparently, lies in the pattern of life in Botswana, where many people have three or four homes—in a town, in a village, at their cattle post and at their farming lands. With handsome revenues from mining, the government has built good roads, which the Batswana use to travel between their holdings, spreading the deadly HI virus as they go.