HIV and AIDS epidemic in Botswana represents the Greatest Development Challenge.

1. IDS Lunch Time Seminar
Botswana’s Biggest
Development Challenge:
HIV / AIDS Crisis
Seonghye ,Tabitha, Doaa, Yumi

2. Outline
 Background
 Theoretical context
 HIV / AIDS Crisis
 The Paradigm Shift of HIV approach
 Socio-cultural perspective
 Gender
 Conclusion

3. A ‘Diamond’ in the Rough?
 Colonial period: ‘benign neglect’
 Independence 1966 – one of poorest countries
 Good governance
 Avoidance of ‘resource curse’
 Upper middle income country
An African miracle?

4. Modernization vs Dependency
Rostow's Development Stages
Dependency??
"...each nation specializing in the output of goods for which it had a
special comparative advantage." (David Ricardo)

5. Economics
-
income inequality
high unemployment
poverty
gender inequality
+
100% primary education
robust healthcare
85% literacy
good infrastructure
'It is arguable that although taking a wider and multi-dimensional view of
development is conceptually correct, per capita GDP still acts as a fairly good proxy
for most aspects of development.’ (Ray 2007)

6. HIV / AIDS Crisis:
Botswana’s Greatest Development Challenge
People living with HIV
Source: UNAIDS

7. Crisis Response
Phase I: 1987-
1989
• Securing
the Blood
Supply
Phase II: 1989-
1997
• Education,
Technical
Phase III: 1997
- present
• Multi-
Sectoral,
Multi-
dimensional
‘We are threatened with extinction. People are dying in chillingly high numbers.
It is a crisis of the first magnitude.’ – President Mogae (2001)

8. The Paradigm Shift
New Infections: Adults 15+
Source: UNAIDS

9. New Policies
 Multi-sectoral approach
 200% increase in health expenditure budget
 Free ARV Therapy - 2002
 Focus on Mother – Child transmission prevention - 2001
 ‘Opt-out’ routine testing - 2004
 Long-term vision - 2016

10. The Paradigm Shift
New Infections: Children <15
Source: UNAIDS

11. The Paradigm Shift
Source: UNAIDS

12. The Paradigm Shift
People living with HIV
Source: UNAIDS

13. Socio-Cultural Perspective
 Realizing the importance of socio-cultural factors by government
 HIV in Botswana
 Cultural beliefs in ‘witchcraft’
 Extreme stigmatization
 Cycles of poverty and inequality
 Marginalized populations: women, female sex workers,
men who have sex with men
Source: Leach 2015
Vaccination Programme in the Gambia
Traditional healer treating
a ‘bewitched’ patient
Source: The Sunday Monitor 2015

14. WID→GAD from late 1970s
Women In Development (WID)→
Gender And Development(GAD)
1975-1985
1981 1997 2013
Women’s Affairs DepartmentThe Women’s Affairs Unit
UN Decade for women
Reviewed laws
WID in Botswana
GLOBAL
Botswana
the Gender Affairs
Department
(GeAD)
more accessible to
health care facilities
Women living with HIV
210,000 compared men
160,000 in 2014
2001
Prevention of mother-
to-child transmission
(PMTCT)

15. Conclusion
 Clear shift of HIV approach around 2000, acknowledging
the significance of socio-cultural aspect.
 Why are 25% of people still living with HIV?
1 people living longer
2 the shift was from top down
3 not a shift in society wide cultural and social practice
4 still gender inequality

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