By Savithri Rodrigo
Botswana (Commonwealth Union)_The battle against HIV/AIDS has not been easy for Botswana, given that it has the fourth largest prevalence of HIV/AIDS in the world and is exposed to one of the world’s biggest threats to HIV/AIDS drug resistance. However, the country persevered and made considerable hard fought gains in the fight against HIV/AIDS.
According to the World Health Organisation, Botswana became the first high-burden country, those with more than 2% of pregnant women living with the virus – to eliminate mother-to-child HIV transmission. Bringing the rate to under 5%, Botswana implemented a strategic plan to provide antenatal care and antiretroviral treatment to more than 90% of pregnant women, to reach the milestone of fewer than 500 per 100,000 live births of HIV cases.
However, that vision did not extend to one of the fundamental challenges facing Sub-Saharan countries – drug resistance. This lack of a comprehensive strategy could put Botswana in danger, facing a setback which may reverse all the hard work put into the fight against HIV/AIDS.
Botswana is one of the few countries in the African continent that hasn’t established an Antimicrobial Resistance National Action Plan. In addition, it has absolutely no knowledge of the extent of its drug resistance threat, which occurs when disease-causing germs become resistant to conventional medication. Infections therefore become harder to treat, which increases the risk of the spread of the disease, severe illness and eventually death.
With little knowledge on the extent of the drug resistance challenge, Botswana only screens for HIV drug resistant variants when patients on treatment have high viral loads, which means, drug resistant HIV variants in patients with low viral loads remain undetected.
The decades of progress made in the management and control of HIV/AIDS, tuberculosis, malaria and STDs therefore are at an exacerbated risk of spreading, most often fatally. The World Health Organisation has been repeatedly calling African countries to invest in sustainable local financing and implementing antimicrobial resistance national action plans focused on infection prevention and control.
