When You Think of Botswana and HIV/AIDS, Think of the Women

by Grace Sedio, Bomme Isago Association

August 6, 2008 - 4:27 pm

Coverage of the International AIDS Conference in Mexico City has once again pointed to Botswana as a "success story" in the fight against HIV/AIDS.  Reporting on new data from the Joint United Nations
Programme on HIV/AIDS (UNAIDS) Brenda Wilson of National Public Radio said:  "Take Botswana, which had one of the highest rates of HIV in Southern Africa.  And the government and international organizations put in strong prevention and treatment programs. Prevalence among teen girls dropped from 25 percent to 18 percent."

I have another side of the story to tell. 

Botswana is a mid-income country and so, was one of the first to provide antiretroviral treatment and
institute programs to prevent mother-to-child transmission of HIV. This is one fundamental reason that we can claim some success. But Botswana continues to have one of the highest HIV rates in the world, and most of the new infections are among women and young people. Today, if you meet 20 young women between the ages of 15 and 24 in Botswana, it is likely that at least 3 of them are living with HIV. The situation in Botswana is controversial because some organizations working in the country have very little understanding of how the rights of women living with HIV/AIDS are being violated.

Yesterday at the International AIDS Conference, I spoke on a panel focusing on what the next phase of the United States’ AIDS response (the President’s Emergency Plan for AIDS Relief-PEPFAR) should look like when it comes to women.  Mary Robinson, former President of Ireland and now with Realizing Rights, opened the session by saying that "We’ve not done better for women and girls [in the fight againstHIV/AIDS] because we have not respected their human rights from thebeginning." 

She is right, and my task on the panel was to describe the situation for women within the PEPFAR-funded
programs and how, so often, their rights are not respected. Let me give you one recent example:

During the last three weeks, I was in the field in Botswana. I came across a project working with
women who are pregnant and living with HIV.  The project intends to provide these women with psychosocial support by linking them with other women who are mothers living with HIV and trained counselors.  The women who work as counselors are asked to sign a contract in order to receive their stipend. The contract requires them to pledge to not to become pregnant while counseling for the program-violating their fundamental right to decide to have a baby or not.

My organization, Bomme Isago Association, is currently involved in monitoring sexual and reproductive
health services for women living with HIV in the country.  Every day, I hear similar stories similar to this one from women throughout Botswana. PEPFAR must do better for we women in Botswana.

Here are just three recommendations
as PEPFAR enters in next five years of implementation:

1. Support sexual and reproductive health services.  Don’t tell us not to get pregnant.  Give us family planning and provide us with safe abortion services if we are pregnant and do not want to have a child.  I do not want to see any woman in Botswana giving birth to an infected child because she was denied full information and services, but the choice of whether to have child or not is hers.
2. Support our human rights.  When I became infected with HIV, I only got the virus, I did not get superpowers.  Women living with HIV still need protection of their rights. My HIV-status does not take away my sexuality or the fact that I am a woman with basic rights over my body and health.
3. Don’t give up on prevention. We are all grateful for the U.S. government’s commitment to providing treatment, but, prevention is equally important.  I do not want anyone else in Botswana to needlessly become infected.

I am optimistic that the world, including PEPFAR, can do better for women.  But, no progress, including
that heralded in my country, will be truly secure without a fundamental commitment to human rights.