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U.S.A P6 billion HIV assistance to Bots

On World AIDS Day (1 December ), we have the opportunity to reflect on our progress in the response to HIV/AIDS and to re-focus our efforts.  This means focusing on the highest impact interventions, bringing them to scale in key geographic areas and among the most vulnerable populations, and maintaining a sense of urgency to get ahead of the epidemic.  This is why my government’s official theme for World AIDS Day 2014 is Focus, Partner, Achieve: An AIDS-free Generation.  The theme captures the core elements of what is needed to reach this goal.

To date, with the generous support of the American people through the President’s Emergency Plan for AIDS Relief (PEPFAR), the U.S. government has committed more than $700 million, or nearly P6 billion pula, to support Botswana’s HIV/AIDS response.  Working in partnership with the Government of Botswana, we have come a long way over the last decade: New HIV infections in Botswana have dropped 71 percent since 2001; Mother-to-child transmission rate has dropped from a peak of around 40 percent to nearly 2 percent; There has been a slow but steady increase in the number of men accessing Safe Male Circumcision as an HIV prevention method; and,

Botswana’s provision of free antiretroviral treatment to its citizens has become a model for the rest of the world. What these figures tell us is that Botswana and the U.S. have begun to change the course of the epidemic here.  But we are not done.  We must continue to invest in evidence-based, high-impact interventions – and advocate for effective health policies – if we are to realise the goal of zero new infections in Botswana.

Option B+ is one of the right things.  This is a program that provides lifelong treatment to HIV-positive pregnant women regardless of their CD4 count. We applaud the Ministry of Health for deciding to adopt this new policy, and the U.S. government is proud to support it.  I am pleased to announce that this support will include $7.5 million in PEPFAR funding.At this time last year, a new study was launched here to determine the best HIV prevention strategies at the community level.  The United States, the Botswana Ministry of Health, and Harvard University announced the four-year project called the Botswana Combination Prevention Project, also known as Ya Tsie.  The $64 million project is being funded by PEPFAR.

Lessons learned from the first year of the study have already provided us with valuable information about future efforts to control and eliminate the HIV/AIDS epidemic in Botswana, and elsewhere on the continent.  We were able to pilot Option B+ prior to the national rollout, and demonstrate the willingness of HIV-positive pregnant and breastfeeding women in Botswana to continue anti-retroviral therapy for life when recommended.  We also learned that using door-to-door, home-based and community HIV testing campaigns can help to successfully identify community members with HIV who were unaware of their status, and to link them to immediate treatment from which they otherwise would not have benefited.  We have reached a critical moment in time where we are close to controlling the epidemic.  We are closer than we have ever been before.  The strong partnership between PEPFAR and Botswana is what will get us there.  By pushing ahead together, an AIDS-free generation is still within our reach.

Speech by Acting US ambassador Michael J. Murphy on World AIDS Day.