ACHAP Performance and Impact Data Summary 2003 - 2008
Description
2008*
2007
2005
2003
OVERALL HIV/AIDS STATISTICS
Estimated HIV+ Population
(total population)
342,000
330,347
307,430
290,633
New HIV Infections (adults only, age 15+)
18,000
18,408
18,708
19,510
Annual AIDS Deaths (adults only, age 15+)
6,500
7,397
10,203
15,254
New HIV Infections (children only, age 0 -14)
870
890
2,185
3,847
Annual AIDS Deaths (children only, age 0 -14)
580
788
1,320
2,902
Total Orphans
131,000
126,666
127,028
116,031
TESTING AND TREATMENT
Percentage of Batswana who knew their HIV status (%)
56**
53.2†
23.9
4.6
Number of Batswana (adults and children) receiving ART by year end
117,045
92,932
58,882
17,723
Number of Batswana (children only) receiving ART by year end
7,051
7,435
3,503
N/A
Percentage of adults and children with advanced HIV infection receiving ART
81.0
83.4
62.7
7.3
Mothers receiving PMTCT
11,791
13,622
9,028
4,685
Percentage of HIV-positive pregnant women who received ART to reduce the risk of mother-to-child transmission
89.0
91.0
60.3
34.3
PREVENTION
HIV Prevalence Rate
(age 15-49)
25.0
25.7
25.4
25.5
Adjusted HIV prevalence rate among pregnant women
N/A***
33.7
32.4
37.4
HIV prevalence rate among pregnant women aged 15-19
N/A***
17.2
18.1
22.8
Percentage of infants born to HIV -infected mothers who are infected (%)
4.0
4.8
11.5
20.7
Percentage of HIV-positive births (as a % of total births) (%)
1.6
1.7
4.1
7.5
Percentage of the blood supply that was HIV positive (%)
1.4
2.2
4.0
7.7
INFRASTRUCTURE DEVELOPMENT AND CAPACITY BUILDING
Number of health care workers trained through the ACHAP program
6,300
5,518
4,205
1,041
Number of infectious disease care clinics and satellite facilities constructed to screen and treat patients with HIV and AIDS
35
32
21
20
* Source: Stover, J (2008). HIV/AIDS in Botswana; Estimated trends and implications based on surveillance and modeling. Gaborone: NACA and ACHAP. Pp. 20 ** BAIS III (2008) preliminary results estimate that 56% of the population aged 10 – 64 has tested at least once, while 41 percent of those aged 15 – 49 is estimated to have tested within the past 12 months, while for the age group 10 – 64 the percentage who have tested within the past 12 months is estimated at 34 percent *** 2008 antenatal serosurveillance figures not yet available † This figure is likely to be overestimated because reliable data does not exist differentiating between those individuals who were newly tested versus those repeating tests.
Major Achievements
The African Comprehensive HIV/AIDS Partnerships (ACHAP) demonstrates how public/private partnerships can make a meaningful and lasting contribution to a public health challenge on this scale, helping to restore hope and transform the morale and prospects of an entire nation.
ACHAP has made a significant contribution to key aspects of Botswana's response to the HIV and AIDS epidemic and has served as a catalyst for the provision of urgently needed infrastructure, equipment, human resources, training and program support for the Botswana ARV program.
Major achievements include:
Halved the mortality rate in adults, saving over 50,000 lives
Dramatically reduced mother-to-child transmission and reduced new infections among children by 80 percent.
Significantly improved blood supply safety.
As of April 30, 2009, more than 126,000 patients were receiving ARV treatment; this is approximately 84 percent1 of the treatment-eligible population, up from less than 5 percent when the program began and the highest coverage rate in Africa.
Achieved ART compliance rates of 90 percent -- among the highest in the world.
Constructed 35 infectious disease care clinics and trained over 7,000 health workers.
Supported the creation of the National Strategic Framework for HIV and AIDS.
Increased laboratory capacity to enable more than 20,000 patients per year to be tested; turn around time to receive test results dropped from about 6 weeks to one day in 90 percent of centers and to just a few hours in some centers.
Supported the introduction of routine HIV counseling and testing to be part of normal medical care. By the end of December 2008, more than 700,000 tests had been performed in Botswana through routine HIV testing.
In collaboration with Harvard University and the Botswana Ministry of Health, ACHAP has provided training for more than 6,300 of Botswana’s health care workers on eight core modules on HIV and AIDS clinical care, while more than 3,200 physicians, nurses and other health care professionals have received hands-on, clinic-based training from international HIV and AIDS experts through the partnership’s preceptorship program between 2002 and 2006. The preceptorship program has now been incorporated into the ongoing national clinical training program managed by the Government of Botswana.
ACHAP has also made significant contributions in the area of HIV prevention, including the development of a national plan for scaling up prevention, improving condom availability and safe blood transfusion. However, ACHAP has not had the same impact in helping to drive prevention during the first phase of the program as effectively as it did treatment. Interventions need to be rapidly scaled up to slow the spread of HIV infection and meet the ambitious national goal of "Zero new infections by 2016".
Lessons Learned in Botswana
Our work in Botswana has taught us valuable lessons about implementing an appropriate response to HIV and AIDS:
A successful national response to HIV and AIDS requires sound, enabling policy to drive and guide the right course of action
Local, national and international partners must integrate and align all efforts to the national blueprint
Success depends on building local capacity and achieving buy-in at all levels
It is possible to implement effective antiretroviral therapy, even in a resource-limited setting
A sustainable solution must address both treatment and prevention
ACHAP is considered an important model to address the African HIV epidemic and lessons learned can be leveraged to inform positive action in other countries in the region.
ACHAP, Merck and the Gates Foundation continue to communicate the achievements and lessons learned, including tools and techniques that can be applied elsewhere, to interested organizations, universities and conferences worldwide, as well as through publications. Today, Merck is applying these lessons to projects in Nigeria, Côte D'Ivoire and China to help governments, aid organizations and others address HIV and AIDS. And many aspects of the program - such as routine testing with opt-out provisions - are being replicated by governments and projects throughout the developing world.
The content on this page was last modified on September 15, 2009.
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