Health

The Ministry of Health in Botswana is responsible for overseeing the quality and distribution of healthcare throughout the country. Life expectancy at birth was 55 in 2009 according to the World Bank, having previously fallen from a peak of 64.1 in 1990 to a low of 49 in 2002. After Botswana’s 2011 census, current life expectancy is estimated at 54.06 years.

The Cancer Association of Botswana is a voluntary non-governmental organisation. The association is a member of the Union for International Cancer Control.

The Association supplements existing services through provision of cancer prevention and health awareness programmes, facilitating access to health services for cancer patients and offering support and counseling to those affected.

HIV/AIDS in Botswana

Like elsewhere in Sub-Saharan Africa, the economic impact of AIDS is considerable. Economic development spending was cut by 10% in 2002–3 as a result of recurring budget deficits and rising expenditure on healthcare services.

Botswana has been hit very hard by the AIDS pandemic; in 2006 it was estimated that life expectancy at birth had dropped from 65 to 35 years. However, after Botswana’s 2011 census current life expectancy is estimated at 54.06 years.

The prevalence of HIV/AIDS in Botswana was estimated at 25.4% for adults aged 15–49 in 2009 and 21.9% in 2013, exceeded by Lesotho and Swaziland in sub-Saharan African nations.

This places Botswana at the third highest prevalence in the world, in 2013, while “leading the way in prevention and treatment programmes”. In 2003, the government began a comprehensive program involving free or cheap generic antiretroviral drugs as well as an information campaign designed to stop the spread of the virus; in 2013, over 40% of adults in Botswana had access to antiretroviral therapy.

In the age group of 15–19 years old, prevalence was estimated at about 6% for females and 3.5% for males in 2013, and for the 20–24 age group, 15% for females and 5% for males.

Botswana is one of 21 priority countries identified by the UN AIDS group in 2011 in the Global Plan to eliminate new HIV infections among children and to keep their mothers alive. From 2009 to 2013, the country saw a decrease over 50% in new HIV infections in children.

A further measure of the success, or reason for hope, in dealing with HIV in Botswana, is that less than 10% of pregnant HIV-infected women were not receiving antiretroviral medications in 2013, with a corresponding large decrease (over 50%) in the number of new HIV infections in children under 5.

40 Among the UN Global Plan countries, people living with HIV in Botswana have the highest percentage receiving antiretroviral treatment: about 75% for adults (age 15+) and about 98% for children.

With a nationwide Prevention of Mother-to-Child Transmission program, Botswana has reduced HIV transmission from infected mothers to their children from about 40% to just 4%.

Under the leadership of Festus Mogae, the Government of Botswana solicited outside help in fighting HIV/AIDS and received early support from the Bill and Melinda Gates Foundation, the Merck Foundation, and together formed the African Comprehensive HIV/AIDS Partnership (ACHAP).

Other early partners include the Botswana-Harvard AIDS Institute, of the Harvard School of Public Health and the Botswana-UPenn Partnership of the University of Pennsylvania. According to the 2011 UNAIDS Report, universal access to treatment – defined as 80% coverage or greater – has been achieved in Botswana.

Potential reasons for Botswana’s high HIV prevalence include concurrent sexual partnerships, transactional sex, cross-generational sex, and a significant number of people who travel outside of their local communities in pursuit of work.

The polyamorous nature of many sexual relationships further impacts the health situation, to the extent that it has given rise to a love vocabulary that is unique to the region.