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National AIDS Council Meeting of 13/08/11

The National AIDS Council met on August 13 to discuss the draft Botswana National Policy on HIV and AIDS and make recommendations to cabinet regarding some issues raised by parliament during the July/August sitting.

This followed the decision by the Minister for Presidential Affairs and Public Administration Mokgweetsi Masisi to suspend the motion to pass the policy in its current form as it did not address contemporary issues such as those relating to key populations and most at risk groups which include sex workers, homosexuals and prisoners. 

The draft 2008 National Policy on HIV and AIDS was developed in 2007 and submitted to cabinet in 2008. Since then, the global and national HIV landscape has dramatically changed.

The following issues were brought before the National AIDS Council for discussion;

• HIV testing of disciplined forces; The Public Health Act prohibits mandatory HIV testing for everybody in Botswana. A consensus was reached that since HIV testing is part of the medical examination package, testing should continue provided the results are not used to weed-out would be soldiers and police officers. The council agreed that measures be put in place to eliminate discrimination and that those found to be HIV positive be assisted.

• Pre-employment testing for expatriates; A consensus was reached that this was not longer necessary as HIV testing is part of the medical exam package and that it was done at the time when government was burdened with high repatriation fees for expatriate workers who died in the country in the late 90s.

• Provision of condoms in prisons; The council agreed that prison inmates are amongst groups most at risk of HIV infection and that the need to prevent new HIV infections overrides all other considerations. The National AIDS Council recommended that prison act which prohibits provision of condoms to inmates be looked at that measures be put in place to halt the spread of new HIV infections in prisons. The council was also cognizance of the fact that although Botswana’s penal code prohibits sodomy as it is against the order of nature, there is no law against provision of condoms.

• Provision of free ARVs for foreign inmates; The Council concurred that foreign inmates are faced with a double vulnerability due to failure to access ARV treatment in Botswana prisons. It was agreed that in prison, cross infection can occur between foreign inmates and locals. The Council recommended that the Botswana Government is duty bound to care for the inmates within its prisons and that ARV treatment be included in the health care package.

• Provision of free ARVs for foreign nationals; The council recommended that the foreign nationals be classified such as expatriates workers, refugees, residents and illegal immigrants in order to determine their needs. A consensus was reached that currently, the Botswana government cannot afford free ARV treatment for non-citizens. The Council concurred that although the government of Botswana government cannot afford to provide free ARV treatment to foreign nationals, they are not denied access to treatment. The council called for foreigners to be encouraged to have health insurance. 

• Decriminalization of sex work; The council acknowledged the extent of sex work in Botswana and its potential to contribute new HIV infections. It agreed that sex workers are often vulnerable to HIV infection through violence and other factors associated with social and economic status. The recommendation is that sex work be decriminalized and regulated so that those in the trade could be protected.

• Decriminalization of homosexuality; The council acknowledged the existence of homosexuality in the sexual networks in Botswana and the potential of Men having Sex with Men to contribute to new HIV infections. Despite homosexuality being illegal in Botswana, the Council highlighted the need to train service providers to improve service provision to homosexuals to protect this group most vulnerable to HIV infection

In conclusion, the council recommended that the draft policy needs to mention key populations such as sex workers, and prisoners who have been highlighted by studies as being most at risk of HIV infection. Decriminalization was recommended but to be addressed as an addendum to the draft policy when it goes to cabinet so that it does not cloud their consideration on other issues.

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