Botswana AIDS drug queues mushroom as patients die
Last Updated: 2004-07-26

GABORONE (Reuters) – Botswana, with the highest per-capita rate of HIV infection in world, is struggling to cope with the demand for treatment, despite pouring much of its diamond wealth into the battle against the killer disease.

"We are faced with an ever worsening, perpetual, insatiable demand," Ernest Darkoh, operations manager for Botswana’s antiretroviral (ARV) drugs programme, told a United Nations meeting on HIV/AIDS in the capital Gaborone on Monday.

"We do not have the staff to deal with it … The critically ill and dying clog the system. Those at the back of the queue we only get around to when they are also dying," he said.

Botswana is seen as a model among African countries in fighting HIV/AIDS, earning plaudits as the first African country to give out free antiretroviral drugs.

Its infection rate of over 37 percent of adults is equalled only by that of nearby Swaziland.

A large, arid country of just 1.7 million people to the north of South Africa, Botswana has funded its campaign through vast dollar earnings from some of the highest-quality diamonds in the world, coupled with massive aid from foreign governments and drug firms as well as private trusts like the Bill & Melinda Gates Foundation.

But Darkoh’s comments revealed that even one of Africa’s richest countries is struggling to come to grips with its AIDS epidemic – a gloomy sign for countries such as neighbouring South Africa, which are only now beginning to roll out their own drug treatment programmes.

Darkoh said efforts to speed drugs to those in need were still inadequate, and the rollout had not been fast enough to keep infected people healthy.

"Phased rollout created an early perverse demand, the answer is to roll out quickly," he said.

"Our phased programme was soon overwhelmed by the critically ill, who travelled from all parts of the country to the few sites which were at first operating. Treating these really sick took five to six times the resources needed for those in the early phases of the disease. We were overwhelmed."

Darkoh runs Botswana’s antiretroviral drugs programme, which since January 2002 has provided drugs to 17,372 people at 18 sites across Botswana, out of a total 27,699 registered as medically eligible for treatment.

A further 6,600 people receive antiretrovirals under private medical schemes, notably by diamond miner Debswana, a joint venture between the government and diamond giant De Beers.

Health Minister Lesogo Motsumi said at this month’s 15th International AIDS Conference in Bangkok that Botswana would meet its target of getting 50,000 on to antiretrovirals by 2005.

That would still be only half the estimated 100,000 people in Botswana who need immediate treatment, but compares with an average of just 4 percent for Africa as a whole.