Botswana’s leader defends AIDS testing

GABORONE, Botswana — Foreign criticism of routine HIV testing in Botswana, the world’s hardest-hit country, inadvertently is hampering the treatment of the sick, President Festus Mogae said.

“I am dissatisfied because of the rigmarole one has to undertake,” a visibly irritated Mr. Mogae said at his Gaborone office on Friday.

“Because of the [outside] criticisms and apprehensions that were expressed, we have to prescribe an elaborate procedure for offering routine testing.

“So we are covering fewer people than we had hoped in order to accommodate the critics. We think it is a pity. We are making progress, but slower than we had hoped.”

Botswana, which has the world’s highest HIV-prevalence rates with nearly 40 percent of the adult population testing positive, adopted a policy of “routine testing” for the virus that causes AIDS.

Anyone who comes in contact with the national health care system, for any health care problem, is automatically invited — and strongly encouraged — to take an AIDS test.

Those who are found negative can protect themselves from infection. Those found positive can be enrolled in a national program for free treatment. Testing is voluntary, although the president would prefer it was mandatory.

But critics in the United States and Europe, while praising Mr. Mogae for providing his countrymen with free antiretroviral (ARV) treatment, charge the policy smacks of forced testing and violates the public’s human rights and right to privacy.

Mr. Mogae countered that his people are dying. An estimated 300,000 people in Botswana have HIV, but after three years, only 80,000 have been tested, with just 21,000 enrolling in the national ARV-therapy program.

“We never envisioned that we’d be able to enroll the whole 300,000. Our realistic target is 110,000. We had hoped that by now we’d have 60,000 or thereabout enrolled. These figures are much lower than we expected. It is slower than we’d like,” he said.

Still devising new ways to boost enrollment, Mr. Mogae said he plans to require students applying for scholarships to take the test, although the outcome of the tests will not affect their eligibility for the scholarships.

“I know it won’t be popular,” he said. “But I think we are going to do it anyway.”

Botswana, a landlocked nation slightly smaller than Texas, gained independence in 1966. At that time, the average resident lived on $50 a year and only 64 persons had gone beyond high school.

But diamonds were discovered, and today, Botswana produces 30 percent of the world’s diamonds. Independent experts say the government, unlike some of its neighbors, has not squandered or stolen the proceeds.

Mr. Mogae took office in 1998 and is expected to win a new term in elections this September. The nation has enjoyed average economic growth of 7 percent annually over 30 years and is trying to become a financial center for the region.

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