Saturday, December 6, 2008

Keynote Address by His Excellency President Lieutenant-General Seretse Khama Ian Khama at the 2008 World Aids Day Commemoration, Selebi-Phikwe

source: Republic of Botswana (6/12/08): TAUTONA TIMES no 40 of 2008
The Weekly Electronic Press Circular of the Office of the President “Democracy, Development, Dignity and Discipline”


[Salutations]…Ladies and Gentlemen,

1. Today marks the World Aids Day Commemoration, a day so designated by the United Nations. It is on this day that we remember those of our fellow citizens who succumbed to the scourge.

2. It is in this regard therefore that today, I call upon the people of Botswana to come together in deed and in spirit, to take stock of our past actions to assess our achievements and challenges in our fight against HIV and AIDS. Let us commit to re-energising and strengthening our efforts as we forge ahead.

3. We will all recall that three years ago, the international community of which we are a part agreed that our key global theme for the period 2005-2010 is to ‘Stop AIDS’ and to ‘Keep the Promise’.

4. There could not have been a simpler and more relevant call on all of us to enter into a more definitive social contract. We all agreed to enter into this contract with ourselves and between ourselves. It is therefore imperative that we must account today. Each one of us must attempt to answer these questions, among others: Did I keep the promise? Did I contribute in any meaningful way towards stopping the spread of AIDS?

5. The global community again agreed to adopt last year a sub - theme that promoted “Leadership in the Fight Against HIV and AIDS”. We adopted this theme in Letlhakeng in 2007.

6. Today, the people of Bobirwa and Selibe-Phikwe are also speaking. They have committed that “Behaviour Change is My Key Responsibility to Stop HIV and AIDS”. I could not agree more with this commitment. To this end, I urge all of us, as Batswana, to embrace and implement this as a life-time contract.

7. I wish to point out that this could not have been agreed at more relevant places than in the Bobirwa sub district and Selibe-Phikwe. HIV prevalence in Selibe-Phikwe was estimated at 23.3% and 18.2% in Central Bobonong (which includes Bobirwa sub-district), in 2004. These areas, together with Chobe and Francistown, are the epicentre of the epidemic in this country, hence the decision that they co-host this commemoration.

8. These two areas indeed have more serious challenges than any other in the country. Undoubtedly, there is an urgent need for behaviour change to stop further HIV infections in Selibe-Phikwe and Bobirwa, in particular. I therefore challenge these districts to do all in their power to provide leadership in behavioural change and lower the current infection rates.

9. I am equally challenging every individual here and elsewhere in this country to innovate around their different but rich cultures to change behaviour, in order to prevent new infections and stop AIDS. That Prevention is better than cure rings true hence prevention is our priority.

10. In the State of the Nation Address, I reported to you that, last year alone, “we spent over P1.4 billion, 90% of which came from our domestic resources” to fight the epidemic. I wish to reiterate that “no amount of money can compensate for the need for greater commitment”. This is especially so since this level of response is unsustainable in the face of other competing development imperatives. At this rate, continued progress cannot be guaranteed. This must be a concern for every citizen.

11. You will recall that we have been basing our plans on an estimate that 110,000 patients were in need of treatment. This is an estimate that was more relevant for 2001. We now estimate the number of people in need of treatment, in 2008, to be 145,000. As at the end of September this year, we treated over 113,000 HIV patients.

12. Our ARV treatment coverage in absolute numbers has been consistently increasing since inception; largely due to the roll-out of the programme to the more remote areas of the country. Again as at the end of September this year, a total of 81 satellite clinics offered ARVs on site.

13. We continue to explore more effective and efficient ways to deliver treatment. As part of the effort, we are tapping the excess capacity in the private sector to build sustainable partnerships for improved service delivery. We are thus outsourcing to the sector to save more lives. According to current estimates, this programme is so far estimated to have averted 50,000 adult deaths by the end of 2007. And assuming the same rate of coverage, we project that cumulatively over 130,000 deaths will have been averted by 2016.

14. To continue to reap these benefits, every Motswana who is on treatment must know that this is a personal lifetime contract. Though this contract may be considered to be strictly personal, the tax-payer is the sponsor. For this reason, each citizen on treatment is responsible and accountable to the tax-payer and by extension, to the nation. The nation therefore demands that every citizen must access treatment on time and all on treatment must adhere. This calls for individual discipline.

15. In view of the enormous costs associated with treatment we must therefore explore other financing mechanisms.

16. It is critical that we should improve the efficiencies around this programme in order to contribute effectively to its sustainability and to achieve more with less. This is especially that we estimate that, at the current rates of infection, about 220,600 Batswana will need treatment by the end of 2016. Inevitably, the costs will escalate.

17. Indeed the success of ARV treatment has reduced AIDS related or induced morbidity and mortality.

18. At this juncture, I wish to recognise and salute all those who partnered with Government by providing their volunteer services in supporting and caring for fellow citizens, who have had the misfortune of losing their loved ones and those who may be terminally ill. No doubt, this support and care has restored their dignity.

19. In the same way we have experienced significant successes in treatment, we are witnessing even greater success in the prevention of mother to child transmission of HIV. Between 1999 and to date, out of every 100 children born to HIV positive women, the number born free of the virus have increased from 60 to 96 children; due to prophylactic treatment.

20. This, coupled with the average enrolment of close to 90%, gives us hope that we are gradually approaching achievement of our goal of an HIV free generation. It is only a matter of time now. This is especially so since it has now been decided, as a matter of policy, that resources permitting, during the next financial year, all HIV positive pregnant women will be put on the Highly Active Anti-Retroviral Therapy. More children are therefore likely to be saved.

21. In my acknowledgement of our successes, I have intimated that drugs can do so much in saving our lives, but the rest can only be done by discipline. I am concerned that so many years after we have offered free services, only about 60% of Batswana have tested to date.

22. Let me assure you that as we continue our battle against this epidemic, we will vary strategies where we feel it is necessary to strengthen our response. It is against this backdrop I take a firm and clear position against alcohol consumption in this country. In the context of HIV and AIDS, it has been concluded that those who drink heavily are at a higher risk of engaging in unprotected sex than those who drink less, and are more likely to do so with multiple partners. These complex and risky behaviours are the main drivers of the virus among our people. Therefore, it would be irresponsible for us to fold our arms and watch as many of our beloved ones go to their graves prematurely. Hence, we must adopt HIV prevention strategies that will integrate alcohol and substance abuse into the national response.

23. Let me take this opportunity to thank my predecessor, Former President, Rre Festus Mogae for having agreed to chair the National AIDS Council compelled by the need to harness his renowned competencies and immense experience in this area, for the good of our nation.

24. I know that you will all join me in congratulating Rre Mogae for having been appointed the Chairperson of the Champions of an HIV Free Generation. This is a structure that is sponsored by our international partners but serving sub-Saharan Africa to advocate for a more effective response against HIV and AIDS. This is testimony to the abilities Rre Mogae has; we are proud of him.

25. My Office is represented by His Honour the Vice President, Lieutenant General Mompati Merafhe in the Council. He is the Vice-Chairperson, whilst the Minister for Presidential Affairs and Public Administration, is also member of the Council. It is in view of the gravity of the HIV situation in this country that I have put together this high level leadership to guide us.

26. In conclusion, let me seize this opportunity to humbly thank all our development partners, donors and members of the international community, both public and private, for their selfless and consistent contribution to this country’s fight against HIV and AIDS. We cannot overplay the need for predictability during these uncertain times. I therefore look forward to their continued support. Your presence here today speaks volumes for our partnership.

27. Last but not least, I wish to applaud the Civil Society including the private sector for the part they play in this response. Government continues to work towards a more conducive environment that enables greater and more meaningful participation. We still have more to do together. Government cannot win this war alone. I thank you and may God bless you all. PULA!

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