Botswana’s AIDS Drug Program Lacks Capacity To Meet ‘Perpetual, Insatiable’ Demand, Official Says

Botswana's antiretroviral drug program lacks the capacity to meet the country's "ever worsening, perpetual, insatiable demand," Ernest Darkoh, operations manager for the country's drug program, said at a U.N. fact-finding conference on Monday, Reuters reports. "We do not have the staff to deal with it ... [t]he critically ill and dying clog the system," Darkoh said, adding, "Those at the back of the queue we only get around to when they are also dying" (Baxter, Reuters, 7/26). The country's outdated health infrastructure and lack of health workers could be causes for the problem, Darkoh said at the U.N. Commission on HIV/AIDS and Governance in Africa conference. Darkoh also said that the program's "phased rollout" strategy was problematic, according to the South African Press Association. "Our phased program was soon overwhelmed by critically ill," who "took five to six times the resources needed for those in the early phases of the disease," Darkoh said, adding, "The answer is to roll out quickly" (South African Press Association, 7/26).

Africa
Botswana, which has the highest per capita HIV prevalence rate in the world, is the first country in Africa to provide free antiretrovirals to HIV-positive people through a program funded by profits from its diamond industry, donor governments, drug firms and organizations. Since January 2002, the country's antiretroviral drug program has provided free drugs to 17,372 patients out of a total 27,699 registered for treatment. An additional 6,600 patients receive treatment under private medical programs (Reuters, 7/26). Health Minister Lesego Motsumi said at the XV International AIDS Conference earlier this month that Botswana by next year will meet its target of distributing antiretroviral drugs at no cost to about 50% of those who need them -- about 50,000 HIV-positive people (Kaiser Daily HIV/AIDS Report, 7/15). However, Darkoh said that the efforts are still "inadequate," and the rollout has not been "fast enough to keep infected people healthy," according to Reuters. Darkoh's comments are a "gloomy sign" for other African countries that are just beginning to implement their antiretroviral drug programs, according to Reuters (Reuters, 7/26). The meeting was the first of at least four UNCHGA meetings, which will be held in different African countries. "We have to find ways in which we can advise policy makers in Africa in these, and other, areas. We have to come up ahead of the epidemic, rather than run behind as we constantly do," Joy Phumaphi, UNCHGA commissioner and deputy director of the World Health Organization, said (South African Press Association, 7/26).