Offices and Departments

Center for Diseases Control

The BOTUSA Project

A Collaboration of the Botswana Government and the US Center for Diseases Control and Prevention

Republic of Botswana
581,700 sq km (226,900 sq mi)
1.7 million
Capital City Gaborone
http://www.cdc.gov/nchstp/od/gap/countries/botswana.htm

The HIV/AIDS Situation in Botswana Botswana ranks as one of the countries hardest hit by the worldwide HIV pandemic.

• 35.4% of pregnant women were HIV positive in 2002 (National AIDS Coordinating Agency [NACA]).
  
• There were 24,000 AIDS deaths in 2001; at the end of 2001 there were 69,000 AIDS orphans and 330,000 people living with HIV/AIDS (UNAIDS).
  
• Currently, life expectancy is 33.9 years, without AIDS it would be 72.4 years (U.S. Census Bureau).
  
• Every year approximately 5,500 babies are infected with in Botswana.

The BOTUSA Project

A dozen international staff and more than one hundred local technical and support staff work in the BOTUSA Project – a collaboration of the Botswana government and the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services. The BOTUSA Project provides technical assistance, consultation, and funding; implements programs; and conducts research with the Botswana government and other local and international partners for prevention, care and support, and surveillance of HIV/AIDS, tuberculosis, and sexually transmitted diseases (STDs).

Specific BOTUSA programs and accomplishments

Prevention

• Voluntary Counseling and Testing (VCT): Opened 16 “Tebelopele” VCT centers in support of Botswana’s “Know Your Status” campaign. Demand for HIV testing is high – at least 50,000 clients will be counseled and tested in 2003. Also providing technical assistance to partners to expand services to other settings.
  
• Prevention of Mother-to-Child HIV Transmission (PMTCT): Helped develop educational materials, train counselors, and provide technical assistance and support. Helped improve infrastructure nationwide, and helping establish a multidisciplinary PMTCT operational research project in Francistown.
  
• Behavior Change Communications: Worked with government and others to develop an entertaining, highly popular Setswana radio serial drama, Makgabaneng, focusing on culturally specific AIDS-related issues. More than 150 episodes have been aired throughout the country over Radio Botswana.
  
• Youth: Supporting the Youth Health Organization (YOHO), a youth-run NGO, to mobilize youth and offer comprehensive youth reproductive health education.
  
• Total Community Mobilization: A nationwide door-to-door HIV education program, co-sponsored with the Botswana government, provides person-to-person HIV education and condom distribution.
  
• School Education: Developing Botswana-specific HIV/AIDS materials for students at the primary and secondary levels with the Ministry of Education.
  
• Workplace: Developed, pilot tested, and distributing a workplace peer counseling curriculum and facilitators’ manual with local businesses.

Comprehensive Care, Treatment and Support

• Isoniazid Preventive Therapy for tuberculosis (IPT): Following a successful pilot, the IPT program is being expanded nationwide to prevent tuberculosis, the leading cause of death among adults with AIDS in Botswana.
  
• HIV Therapy: Supporting training for health workers and increasing laboratory capacity for monitoring patients on HIV drugs in collaboration with the Gates and Merck Foundations, the Harvard AIDS Institute, and the U.S. Health Resources and Services Administration (HRSA).
  
• Sexually Transmitted Disease Treatment: Evaluated treatment algorithms and supporting training using updated treatment guidelines.
  
• Faith-Based Counseling: Working with an NGO to develop a countrywide network of 125 church-based, volunteer counselors to provide HIV/AIDS community counseling.

Surveillance, Monitoring and Evaluation, and Capacity Building

• HIV Surveillance: A CDC medical epidemiologist is working full time with NACA to strengthen capacity in surveillance and program monitoring and evaluation.
  
• TB Surveillance: Introduced and supporting use of the Electronic TB Register, a computerized TB surveillance system, in Botswana and six other countries.
  
• Laboratory Quality Assurance: Providing technical assistance and training in quality management to the National Medical Laboratory Quality Assurance Committee.
  
• Management Training: Strengthening the management and leadership skills of managers in the NGO and public health settings.

Research

• Research is ongoing on the epidemiology of TB/HIV, as well as studies to improve TB prevention, diagnosis, and treatment.
  
• Preparations are underway for clinical trials of vaginal microbicides women could use to prevent transmission of HIV and other STDs.

Priorities for Future Action

• Improve nationwide coverage with programs for prevention, care, and surveillance of HIV/AIDS and related infections.
  
• Continue to conduct and implement findings from relevant clinical and operational research.
  
• Strengthen the capacity of the BOTUSA Project to support the many ongoing and planned initiatives in response to the HIV/AIDS epidemic in Botswana.
  
• Improve coordination with the government of Botswana, NGOs, and other development partners.

Our vision: "A healthier Botswana through elimination of HIV/AIDS, tuberculosis, and sexually transmitted diseases."