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HIV Prevention in Botswana
HIV Prevention

The Government of Botswana has made a commitment to achieving the goal of “Zero New Infections by 2016”.  The National Operational Plan for Scaling Up HIV Prevention in Botswana matches this vision with an aggressive prevention implementation program, building on the National Strategic Framework, that will fill the gaps in current programming and intensify, unify and scale up the response. The strategic emphasis for the next phase of the National Strategic Framework (NSF) and beyond must be on taking prevention to scale. UNAIDS defines “scaling up” as ensuring that the appropriate mix of evidence-based prevention strategies achieves a sufficient level of coverage, uptake, intensity and duration to have optimal public health effect.

The Plan ensures that priority is accorded to the most important issues, and that resources are allocated to interventions with the greatest potential impact for preventing new HIV infections. The Plan provides a framework for addressing cross-cutting issues such as capacity strengthening for effective implementation, as well as coordination and management. It also provides a framework for research monitoring and evaluation within the existing framework of the Botswana HIV Response Information Management System (BHRIMS).  Finally, it provides an estimate of financial resources needed to implement the Plan.  Many players and commentators have echoed the fact if Botswana waged a sustained prevention programme there might be hope that over time, as the anti-AIDS messages sink in, the rate of infections will fall and there will be a smaller number of people needing the drugs. The potential savings to Botswana are immense, but the most compelling reason to intensify HIV prevention interventions is to reduce human suffering—the physical, emotional and spiritual pain that individuals, families and communities endure as a result of AIDS.

The NSF Mid-term Review noted that “Our focus must shift to prevention, and our prevention efforts have to work. There is no other course open to the national response; no other course that has the potential to break the back of this epidemic… Prevention is our one and only real survival strategy.”
The goal of prevention in Botswana is to achieve significant and measurable progress towards “Zero New Infections as described in Vision 2016. The Operational Plan does set the direction within the broader context of the National Strategic Framework 2003-2009 for realizing this goal. The central pillar of the Prevention Plan is the “minimum package.” This is a set of interventions which, if implemented simultaneously with sufficient reach, intensity, and duration, has the potential to dramatically reduce further transmission of HIV in Botswana.  The minimum package includes:

1. Prevention of sexual transmission
2. HIV counselling and testing (HCT)
3. Preventing mother to child transmission of HIV (PMTCT)
4. Sexually transmitted infection (STI) management
5. Preventing Blood Borne Transmission

Botswana is committed to implementing the prevention programme through strategic communication and related community interventions in the following basic categories:

The national strategic communication harmonizing and support functions.  A number of centralized functions including branding, materials development, national harmonization and collaboration, clearinghouse operations, training and capacity-building, research and evaluation help to ensure consistency, quality and economies of scale. 
Strategic Communication to Prevent Sexual Transmission.  The approach focuses on addressing the key determinants of sexual transmission to increase the use of primary prevention behaviours, and increasing “Prevention with Positives.”
Communication Support to HIV/AIDS Services components of the Minimum Package to increase demand for and improve client education and client use of HCT, PMTCT, STI, and Blood Borne Transmission.   Also, it enhances interaction between service delivery sites and the communities they serve.
Community mobilization is a participatory process that increases a community’s sense of ownership and collective efficacy. It is a transformative process, shifting a community from “recipients” or “beneficiaries” of “projects” to active planners and participants in the health and well being of the community and its members.


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