Free antiretroviral campaign might not last

Botswana's campaign to provide free antiretrovirals (ARV) to HIV positive patients may not be sustainable over a lengthy period, President Festus Mogae said this week. The programme would cost US $24.5 million in 2002 and would cover 19,000 people, the South African Press Association reported. Thereafter 20,000 more people would be admitted to the programme each remaining year of the five year programme, the report added. "The programme is most likely not sustainable at that level. Our hope is that over time, as the anti-AIDS messages sink in - our youth are starting to listen - the rate of infections will fall and there will be a smaller number of people needing the drugs," Mogae was quoted as saying in the report. Dr C Onen, programme manager for the country's ARV project, remained optimistic, however, that the programme would continue after five years. "This is a lifelong commitment and hopefully resources will become available afterwards," he told PlusNews on Thursday. Findings from the McKenzie feasibility report estimated that 110,000 of the 290,000 people infected with HIV/AIDS in the country would receive free ARV drugs. As a result of poor resources - laboratory capacity, human resources and poor infrastructure - it was decided to initially target certain population groups, said Onen. Patients suffering from tubercolosis (TB), mothers, babies and their spouses, as well as patients with a CD 4 count of 200 were some of the groups targeted. This year, 19,000 people at four major sites in urban and rural areas will receive the free ARV drugs. The drugs have already been bought and are currently in stock, he said. The projected date of the start of the programme was in mid-October last year but this had been "completely unrealistic" he added. "This is an ambitious plan for any country," said Onen. Teething problems were inevitable, but the project had learned from these. According to Onen, there were several stages to go through before the successful implementation of the programme. People who had already been diagnosed with HIV/AIDS had to be enrolled in the programme and then undergo CD4 testing and evaluation. The dissemination of information about the programme was another important aspect of the campaign, he said. Two hospitals in Gaborone were "set to start" as they had a proper infrastructure and had already been successfully treating HIV positive patients, said Onen.