Speech by His Honour The Vice President, Lt. Gen. Mompati S. Merafhe, MP, at the Official Opening of the 2nd Botswana International HIV Conference

source: Republic of Botswana (20/9/08): TAUTONA TIMES no 28 of 2008
The Weekly Electronic Press Circular of the Office of the President "Democracy, Development, Dignity and Discipline"

B2) 17/9/08: Speech by His Honour The Vice President, Lt. Gen. Mompati S. Merafhe, MP, at the Official Opening of the 2nd Botswana International HIV Conference Organised by Botswana Clinicians Society:

[Salutations]... Ladies and Gentlemen,

1. It is with an immense sense of duty and delight that I join you here this evening to officially open the 2nd Botswana International HIV Conference which, quite appropriately, focuses on one of the key development challenges facing our nation - HIV.

2. I would like to salute the tireless work of the organizers, sponsors, presenters, and all people who have heeded the call to be here this evening. Undoubtedly, the initiative of the Botswana Clinicians Society to hold this conference is a clear demonstration of the commitment of our doctors to the war against HIV and Aids.

3. Let me commend you for this selfless spirit of patriotism, compassion and partnership that is truly characteristic of the medical profession itself. I hope the next few days you will spend away from your patients will not only give you an opportunity to reflect on the cutting edge advances in the prevention of HIV and the treatment and care of people living with HIV, but will also provide an opportunity for you to confer on possible innovative ways of improving delivery of quality health care in general to many people who need it.

4. Allow me, Director of Ceremonies, to welcome all those friends of Botswana coming from outside and thank them for their friendship and support. Please feel free to remain behind after this Conference to go into the country side to spoil yourselves with the pristine beauty of our wildlife and the hospitality of our friendly people.

5. Director of Ceremonies, Distinguished Ladies and Gentlemen, I am intrigued by the theme for this year's Conference: Bold New Steps. It reminds me of the title of Sir Ketumile Masire's book 'Very Brave or Very Foolish' in which he chronicles how Botswana has in the past never shied away from taking bold and new steps in dealing with its development challenges.

6. While some perceived this boldness as a dangerous leap in the dark, it has however, served us well in the past; it is doing so currently in our response to the HIV scourge and for the foreseeable future we shall certainly rely on this "Very Bravery" to confront national challenges head on. Indeed when we took the early bold steps to address this mammoth challenge we embarked on the following without much hesitation:

* Declaring to the world that HIV and Aids was threatening to wipe our population from the face of the earth;
* Declaration of war on HIV, including the setting up of a coordinated and comprehensive national response focusing on prevention, treatment and care;
* This response led by government in close collaboration with development partners, private sector, NGO's and local communities led to the establishment of structures such as the National Aids Council, NACA, DMSAC and the formulation of an enabling policy framework and financial commitment towards the fight against HIV;
* Free Voluntary Counselling and Testing (VCT) for HIV;
* Introduction of Prevention of Mother To Child Transmission of HIV (PMTCT), from as early as 1998;
* Free comprehensive National ARV programme the first of its kind, in Africa, in 2002;
* Offering of routine HIV testing in health institutions.

7. Believe it or not, for every bold step one takes there is always a Doubting Thomas. There were people who frowned upon these bold steps, and in particular, the early decision to introduce the Anti-retroviral programme (ARV's) because, in their view, this was not sustainable given the high cost or prices of drugs at the time. We nonetheless persevered.

8. Fortunately, the big pharmaceutical companies, foreign donor governments, especially the United States, and philanthropic organizations, also from the United States, were willing to traverse the difficult terrain with us. They knew that ours was a noble cause - a cause to save lives and assure the prosperity of a young nation. We owe these foreign donors, or shall I say partners, an immense debt of gratitude for their generosity, friendship and understanding.

9. Our determination to fight the scourge with all weapons at our disposal was also tremendously enhanced by the tenacity, vision and passion of none other than Former President, Rre Mogae, who is here with us tonight.

10. I still remember quite vividly Sir, in 2000, at the dawn of the New Millennium, when most of world leaders seemed reticent about the gravity of HIV and AIDS you stood, stoically and without any trepidation, at the podium of the UN General Assembly and made a clarion call to the international community, in particular the United Nations, to respond to the global HIV crisis before it was too late.

11. Yes, your message did not only resonate throughout the hallowed halls of the United Nations, it spurred the UN, which was hitherto lukewarm, into decisive action to deal with HIV and AIDS.

12. We are indeed gratified and inspired that even in your retirement you still have that vitality to be with us in the frontline through your able Chairmanship of the National AIDS Council. Rest assured that your visionary leadership and experience in this area means a lot to us.

13. Ladies and Gentlemen, through Vision 2016, we have committed to ensuring that Botswana will achieve an AIDS free generation in the year 2016. Bold new steps are certainly required if we are to live our Vision. These new steps are even more pertinent and urgent given that there seems to be some creeping complacency which may be due to the perceptible national progress so far registered in the battle, demonstrated by the success of the PMTCT programme.

14. It is also a matter of serious disquiet that recent surveys indicate that half of our population have never tested for HIV and therefore do not know their status.

15. Let me point out that our people are both beneficiaries and agents of HIV programmes and policies. Without their cooperation, and willingness to do the needful, the success which I am sure we are all yearning for, will be difficult to achieve and we would have lost the battle if not the war.

16. As Former President Mogae pertinently observed at the last meeting of the National Aids Council, "We cannot afford to lose this war because losing the war means losing our people."

17. Distinguished Guests, Ladies and Gentlemen, the bold new steps that Botswana is currently taking will be discussed in detail during the course of this conference. I however wish to highlight two developments here in Botswana which are very encouraging if not promising.

18. The first development is that our ongoing PMTCT initiatives have reduced the rate of Mother to Child transmission of HIV from about 40% to about 4%. The scientific evidence that was provided at the 1st Botswana International HIV Conference and other fora addressing the HIV and Aids challenge has indicated that provision of triple ARV therapy could further lower the infection rate from 4% to less than 1%.

19. Government is undertaking a pilot project to offer such Highly Active Anti-Retroviral Therapy (HAART) to pregnant women in Botswana. Should the pilot study demonstrate that such low levels of transmission are achievable even in our population, HAART will be offered universally to our pregnant HIV positive women.

20. Secondly, it has been noted that our people develop serious infections while waiting for their CD4 to reach or pass the stipulated cut-off line of 200 before initiating ARVs. In the new treatment Guidelines, the CD4 enrolment criterion has been increased from 200 to 250.

21. Distinguished Ladies and Gentlemen, it is my belief that the new bold steps that would be recommended by this conference should be informed by some very visible challenges in our society. Among these critical challenges is what can be done to successfully promote zero transmission lifestyles to ensure there are no new HIV infections.

22. It is apparent that in spite of the massive education and awareness campaigns that have been mounted over the years it has generally proved difficult for our people to reflect behavioural change that is compliant with the message of prevention. There is evidence, for instance, that 5% of people re-testing for HIV who were previously HIV negative are now testing positive. This can only undermine our national efforts to achieve a target of no new infections by 2016 and it needs to be tackled as a matter of urgency. Government is keen to receive the resolutions of this conference in this regard.

23. Director of Ceremonies, it would be remiss of me if I concluded these remarks without commending the private sector, foreign governments and international organizations, civil society, communities and faith based organizations for their increasing role in sharing the burden with the Government when it comes to caring for HIV positive patients and the orphans. The partnerships that have been forged will continue to be critical if we are to win the battle against this disease.

24. Director of Ceremonies, Distinguished Ladies and Gentlemen, let me conclude by pointing out that naturally in every journey there is bound to be a hurdle, the life of our nation should not be an exception in this regard. After 40 years of uninterrupted progress and prosperity, we are today faced with the challenge of HIV that if left unchecked could undermine the progress we have so far made.

25. What is fundamental though, is not to bemoan this aberration, but to work together to surmount it and prevail in order to create a better future for our children and many generations yet unborn.

26. May the 2nd Botswana International HIV Conference be a resounding success! Pula!!