Botswana has made significant strides in the fight against HIV/AIDS, and continues to dedicate resources to this cause as evidenced by the launch of yet another preventative strategy. The initiative launched by President Ian Khama on Friday will enable all HIV people to start treatment as soon as diagnosed.
What this means is that all Batswana diagnosed HIV positive will receive antiretrovirals earlier than reaching the 350 CD4 count, which used to be the starting point for treatment. This approach will see approximately 100,000 more people enrolling in the Anti Retroviral Therapy (ART) this month. In the past, there have been instances where people are enrolled in the therapy when they are very weak.
This had a number of implications for instance nutritional complications hence government dug deeper in public coffers to provide food baskets. Moreover, ill-health has contributed to lack of productivity as no human being can deliver optimally when unwell. The previous CD4 count cut-off opened room for stigma, as some people would get treatment when their immune system was at a low.
This move is not only an adherence to the 2013 new HIV treatment guidelines issued by the World Health Organisation, recommending countries start HIV patients on antiretrovirals sooner – when their CD4 counts, a measure of the immune system’s strength fell below 500. We understand the approach would combat whatever side effects the treatment might bring.
This is plausible looking into the fact that the initial ART dispensation neglected to control and manage side effects presented by the treatment. In addition, this approach would help fight high transmission and infection rates as reports indicate that the guidelines drew in part from studies that showed that HIV-positive people who started ARVs at higher CD4 counts were about 96 percent less likely to transmit the virus.
This moves obviously comes with cost implications as the number of people in the ART increases. On the other hand, reduced transmission rates as well as having a nation whose productivity level is not limited by ill health can make up for the financial resources invested towards a lager population on antiretrovals. It is therefore very important for communities to join hands in the war against HIV/AIDS through early and constant HIV testing, adherence to treatment as well as encouraging loved ones, relatives and fellow citizens to test and enroll in ART while still well do that they never have to become sick.
While we applaud the government of Botswana (and partners) for commitment shown over the years, as well as the country’s strong commitment and contribution to the global fight to ending AIDS by 2030, we ask that the same vigor and political will be extended to fight non-communicable diseases, which are modern day silent killers.