01.12.2020-WORLD AIDS DAY BONELA MESSAGE

Theme: Global Solidarity, Shared Responsibility

In the era of the coronavirus pandemic, this year’s 2020 World AIDS Day will be unparalleled. COVID-19 has ruptured wounds and widened the inequalities that already exist within our societies. It moreover, threatens the progress that the world has made in health and gains made so far towards eliminating HIV/AIDS. Thus, as we commemorate World AIDS Day we are reminded to take stock of COVID-19 as a confounding vulnerability in the fight against AIDS. Similarly, we are reminded to take stock of the challenges and multiple vulnerabilities that people face in relation to HIV; due to demographics, socioeconomic circumstances, gender based violence and harmful gender norms, and/or being part of a marginalized community or communities.

The Botswana BBSS Study of 2018 indicated that Sex Workers have the highest HIV prevalence in Botswana, while Men who have Sex with other Men remain increasingly vulnerable to HIV infection.2 The HIV prevalence was recorded at 51.3% among Female Sex Workers in three districts surveyed in 2017 with the unemployment rate among sex workers recorded as 58%.4 The Botswana AIDS Impact Survey (BAIS) conducted in 2013 indicated that adolescent girls and young women in the country carry a higher HIV burden than their male counterparts.2 15 to 19-year-old girls have an HIV prevalence of 6.2% compared to half of that (3.6%) among the boys in the same age group.2 It was also noted that the HIV prevalence of young women aged 20-24 years is three times (14.6%) that of their male counterparts (5%).2 The disproportionate incidence of HIV among adolescent girls and young women as compared to their male partners was further substantiated by the UNICEF Botswana challenge report in 2018.5

The Botswana Investment Case estimated the HIV prevalence amongst prison inmates as 14%.2 It was not until the landmark case in 2014 led by the Botswana Network on Ethics, Law and HIV/AIDS (BONELA), that in 2015 antiretroviral therapy (ART) was freely provided to HIV positive noncitizen prison inmates.3 Additionally, Focus Group Discussions with People with Disabilities (PWD) in Botswana, conducted as part of the 2017 Legal Environment Assessment (LEA) by the Ministry of Health and Wellness in partnership with the UNDP and BONELA, revealed that PWD are not being adequately reached with HIV and other health services.1 Some barriers identified that impede access or fail to facilitate access to health services for include inadequate data on people with disabilities and their health needs and gaps.

The aforementioned populations have and continue to experience challenges associated with breach of confidentiality, poor quality and/or degrading treatment by service providers, as well as societal stigma and discrimination which leads to targeting, blackmail, violence, unemployment and poor educational outcomes; further exacerbating vulnerability to HIV/AIDS.1 The LEA report highlighted that there are a number of policies and laws that should be reviewed which violate people’s right to confidentiality, dignity and privacy causing legal and policy barriers that negatively impact on the national response to HIV/AIDS.

It is against this background that BONELA advocates for a comprehensive approach and targeted interventions to address the barriers caused by multiple vulnerabilities in the fight against HIV/AIDS. A comprehensive and multisectoral approach that addresses service delivery at individual, community, and national level; that allows for tailored messaging and service delivery according to the specific needs of specific clients; that introduces national policies that protect the rights of patients and health care workers alike; and that call for the engagement and inclusion of the community, community health volunteers, people living with HIV, and other key populations in all stages of the HIV treatment cascade. Moreover, at the core of these interventions are human rights that are universal, inalienable, indivisible, interdependent and interrelated. In order to be triumphant in the campaign against HIV/AIDS; we must end the social and political injustices that put people at risk of contracting HIV, and we must fight for the right to health.

Whether it be rebranding of the ART program to implement a “Treat All” strategy to facilitate immediate access to treatment; dispensing multi-month HIV treatment and extending the timeframe between follow up appointments under COVID-19; organizing home based care deliveries of medications; or providing financial assistance, food and shelter for at-risk groups. It is this comradery, strengthened community, shared responsibility, and solidarity that will contribute greatly to the victory over HIV/AIDS. An approach embodied by Botswana’s third National Strategic Framework which acknowledges the role of communities and thus commits that at-least 30% of all HIV programmes be delivered by, and through communities.

BONELA is an organization with an unparalleled track record in advocating for the rights of those most affected by HIV/AIDS. Over the past 20 years, BONELA has relentlessly advocated for a rights based approach to HIV programming, particularly the rights of vulnerable and marginalized populations such as Men who have Sex with other Men (MSM), LGBTI, Sex Workers, children, women, refugees, prisoners, mine workers, people with disabilities, and people living with HIV. Therefore, in recognition of this year’s World AIDS Day commemoration theme: ‘Global Solidarity, Shared Responsibility’, BONELA devotes to share responsibility and pledges to stand in solidarity in the campaign against HIV/AIDS. Moreover, we reaffirm our commitment globally and nationally to advocate for HIV, Health, Gender, and Human Rights; to ensure promotion, protection and fulfilment of the right to Health and to support a human rights based approach to health via awareness raising, capacity building, advocacy, and facilitating access to justice. BONELA reaffirms its commitment to build effective partnerships and work with other Civil Society Organisations, State and Government Representatives, Development Partners, Key Population Networks, Human Rights Offices and Sectors, and various communities to address the social, economic, and political aspects of inequality and exclusion that create barriers to accessing health services, exacerbate vulnerabilities and impede the national response to HIV/AIDS.

BONELA further pays tribute to Civil Society Organizations and HIV programming stakeholders in Botswana who individually and collectively, have contributed immensely to the national response to HIV/AIDS. Ours has always been and will always be an act of national service, characterized by pain, sacrifice, courage but most importantly fulfilment. Let’s continue working hard and working together; the end of AIDS is in sight! To the fallen heroes and heroines of the struggle, we remember, acknowledge and celebrate your efforts under the theme: Global Solidarity, Shared Responsibility.

For more information, contact BONELA on:

+267 3932516 or Cindy Kelemi at cindyk@bonela.org or Tebogo Gareitsanye at tebogog@bonela.org and follow BONELA on Twitter @bonelaethics and like our Facebook Page BONELA

Reference:

  1. Peter P. Chibatamoto & Munyaka W. Makuyana, n.d., A brief legal analysis on sexual and reproductive health rights, policy, law and practice in Botswana.
    1. Focus Group, Sisonke, October 2016, Gaborone; Open Society Initiative for Southern Africa, Rights Not Rescue, A Report on Female, Male, and Trans Sex Workers’ Human Rights in Botswana, Namibia, and South Africa (2009).
    1. https://www.researchgate.net/publication/323231400_Management_of_post_abortion_complicat.
    1. https://www.academia.edu/6529147/Reproductive_Health_and_the_Question_of_Abortion_in_Botswana_A_Review.
    1. https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwjGiN21.
    1. https://www.southernafricalitigationcentre.org/wp-content/uploads/2017/08/Transgender-rights-in-Botswana.pdf.
    1. https://www.mmegi.bw/index.php?sid=1&aid=34&dir=2008/February/Friday22
    1. http://spl.ids.ac.uk/sexworklaw/countries.
    1. https://aidsfonds.org/partner/sisonke-botswana.
    1. https://www.iasociety.org/Web/WebContent/File/IAS2017_PPT_NEO_2.pdf,
    1. https://www.youtube.com/watch?v=nttC6usgU5k
  2. Ministry of Health and Wellness & United Nations Development Program, August 2017, Assessment of Legal and Regulatory Framework for HIV, AIDS and Tuberculosis.
  3. Southern African Litigation Centre, March 2014, News Release: Botswana Government Ordered to Provide HIV Treatment to Non-Citizen Prisoners, https://www.southernafricalitigationcentre.org/2014/03/18/news-release-botswana-government-ordered-to-provide-hiv-treatment-to-non-citizen-prisoners/.
  4. Ministry of Health & Wellness and UNDP, 2018, Behavioural and Biological Surveillance Survey of HIV/STI Among Select High-Risk Sub-Population in Botswana – 2017.
  5. UNICEF Botswana, 2018, https://www.unicef.org/botswana/hiv#:~:text=Among%20the%20370%2C000%20estimated%20people,people%20aged%2015%20%E2%80%93%2024%20years.