Para 49) Government has implemented the following awareness raising programmes for Adolescent Girls and Young Women (AGYW).
Para 50) DREAMS, which is an HIV prevention program that is a partnership between the Government of Botswana and the Government of the United States of America. The coverage of DREAMS increased from two (2) districts in 2020 to eight (8) districts in 2022.
Para 51) The Shuga Radio program, mass multi-media behaviour change communication initiative targeting young people aged 10-24 years in partnership with United Nations International Children’s Emergency Fund (UNICEF), reaching 34,819 Adolescent and Young People between 2020 and 2022.
Para 52) From 2020 to 2022, the program reached 87,782 adolescent girls and young women with HIV prevention messages. 40,946 AGYW were enrolled into safe spaces and received economic strengthening skills while 1,984 received post violence care and 3,845 received Pre-Exposure Prophylaxis. (PrEP).
Para 53) With the support of the Global Fund Matching Funds for AGYW in the 2019-2021; 2022-2024 grant cycles, Botswana received USD 2 million to continue institutionalizing a range of information, skills and values to empower young people to exercise their sexual and reproductive rights, and to make healthier decisions about their health and sexuality by revising the national curriculum.
Para 54) The Life-skills Toolkit (which operationalizes the National Life-skills Framework) provides guidance to implementers (Guidance and Counselling Teachers, Social Workers and health service providers) on delivering CSE to young people at pre-school, primary and secondary school levels, as well as those out of school.
Para 55) The Form 1-3 Guidance and Counselling Curriculum Guidelines and the Living: Skills for Life, Botswana’s Window of Hope complement the toolkit. With the support of the Global Fund, The Ministry of Education is currently reviewing and updating the Life-skills Curriculum as well as developing a Parent-Child Communication Manual.
Para 56) The following are the successes of the measures adopted by Botswana to reduce HIV prevalence among young people:
• With regard to condom distribution, according to the 2020 report of the Global HIV Prevention, Botswana is ranked as one of the best countries in terms of the number of condoms distributed per person per year in sub-Saharan Africa between 2018 and 2019.The report applauds Botswana for managing to narrow the gap regarding preventive benefits of condom use in the 15-49-year age group;
• With regard to the promotion of HIV testing as the entry point to every HIV/AIDS program, Botswana exceeded the World Health Organisation (WHO) 95-95-95 target. This shows that 95.1% of the adult population living with HIV know their status, 98% are on treatment, while 97.7% of those who are on treatment are virally suppressed;
• With regard to Voluntary Male Circumcision (VMMC), cumulative achievement from 2009-2022: 273,983 SMCs were conducted, which translates to 92.5% of the 298,180 needed to be reached by 2022. Of these SMCs 6,021 were done through the Early Infant SMC Project;
• Botswana has also been effective in reducing Mother to Child Transmission of HIV and has reduced direct transmission from mother to child to 2.21%, surpassing the 5% global target. In recognition of this achievement, Botswana became the first African country to be awarded the Silver Tier Certificate on the Path to eliminate of Mother to Child Transmission of HIV by WHO;
• The National comprehensive program to remove human rights and gender related barriers to HIV and TB services which is supported by the Global Fund’s Breaking Down Barriers Initiative covered eleven (11) out of twenty-seven (27) health districts and will gradually be scaled up nationally to promote human rights awareness and capacitate key and vulnerable populations.
Para 58) In addition, Botswana was on 20th September 2022, bestowed with a “National Achievement Award” by the Africa-America Institute (AAI), for effectively containing and managing the spread of HIV, Tuberculosis, and Malaria, among others.
Para 59) Furthermore, the Botswana Guidelines for HIV/STI Programmes for Key Populations was completed in 2020 with the support of United Nations Population Fund (UNFPA). Through the assistance of UNFPA, Government has developed the second National Condom Strategy (SBCC) 2020-2023, which is aligned to the National Strategic Framework III. The main highlights of the national strategy are to Strengthen coordination and condom programming, expand condom market beyond the public sector and address funding and resource gaps.
Para 60) Through social contracting, Government has engaged CSOs in order to increase condom access to the community. 11,613,200 condoms were distributed in 2021 of which 36% were distributed by the various NGOs funded by Government.
Para 61) The following are some of the collaborations between the Government of Botswana and development partners in combating HIV/AIDS:
• U-Report in collaboration with the United Nations International Children’s Emergency Fund (UNICEF);
• Prevention of Mother to Child HIV Transmission in collaboration with United States (U.S) Centres for Disease Control and Prevention (CDC);
• HIV Programmatic response in collaboration with the U.S President’s Emergency Plan for AIDS Relief (PEPFAR);
• Improving the delivery of quality HIV services in partnership with Human Resources for Health (HRH 2030);
• HIV response in partnership with United Nations Programme on HIV/AIDS (UNAIDS);
• HIV research, training and capacity building in collaboration with Harvard AIDS Institute;
• First Lady’s Men’s’ Health Initiative supported by the European Union and UNAIDS;
• Paediatric AIDS initiative in partnership with Baylor College of Medicine International AIDS Initiative;
• Global Fund support the national HIV, Malaria, TB and COVID19 response (2019-2021, 2022-24) grant cycles;
• Sexual Reproductive Health and integration of services supported by United Nations Populations Fund (UNFPA)27;
• The Global Fund supports the national HIV, TB, Malaria and Covid 19 response (2019-2021, 202-2024 grant cycles);
• The UNFPA supports the Government to integrate SRH/HIV and GBV;
• WHO continues to support Government with the technical expertise across different areas of the health sector programs including the investment case for NCDs.
Para 63) Government continues to collaborate with CSOs, development partners and the media in raising awareness for the prevention of HIV.
Para 64) To further combat Gender Based Violence (GBV) in the context of health and HIV/AIDS, the Draft Comprehensive National Plan to Remove Human Rights and Gender Related Barriers to HIV and TB Services includes interventions aimed at reducing gender inequalities, harmful gender norms and gender-based violence. Government continues to collaborate with GBV service providers to reduce vulnerability to HIV and GBV.
Para 65) The Faith and Communities Initiative (FCI) – a PEPFAR supported program reached 66,269 men and boys across the programme interventions. In 2022, the FCI programme scaled up interventions to address stigma and non-adherence related to faith healing as well as harmful gender norms and practices which perpetuate the recently escalating gender-based violence cases.
Para 66) To eliminate stigma and discrimination, Government adopted a Broad-based Stigma and Discrimination Reduction approach. Initiatives include:
• Awareness to reduce gender inequality;
• Training and support of adolescents and young people (AYP) as well as faith-based organisations;
• Community mobilisation and dialogues with traditional leaders;
• Training of service providers and peer educators.
Para 67) The expected outcome of the above include:
• Enhanced capacity for recognising and responding to GBV;
• Enhanced capacity for provision of psycho-social support;
• Rapid response and referral for monitoring and responding to human rights violations;
• Strengthened participation of AGYW as peer educators in HIV prevention for in and out of school youth.
Para 103) With respect to health care providers, there is a comprehensive national plan (2019-2024) to remove human rights and gender related barriers to HIV and TB services. This plan includes interventions to train and capacitate police to collaborate with CSO and health care providers to respond to GBV. This intervention is part of the Joint United Nations Programme on HIV and AIDS (UNAIDS) Seven Key Programmes to remove human rights barriers to HIV and TB services supported by the Global Fund in twenty countries globally through the catalytic/matched funding. Government is currently implementing the Global Fund grant for 2019-2021 and has been allocated further matched funding for the 2022-2025 cycle.
Para 111) … Further, the Five Year National Comprehensive Plan to Remove Human Rights and Gender Related Barriers to HIV and TB identifies harmful gender norms and cultural values as drivers of GBV. As such, Botswana started implementing the seven key programmes to reduce stigma and discrimination recommended by the UNAIDS.
Para 134) The following are the achievements of Government in improving access to health services:
• Free infant formula to babies of HIV infected women who opt to formula feed and meet the AFASS criteria. The percentage of HIV exposed infants on infant formula is around 57%;
Para 4) Noting that Botswana had neither signed nor ratified the International Covenant on Economic, Social and Cultural Rights, BCU stated that this Convention was particularly relevant for the regulation of the right to health, including in the context of HIV.
Para 43) BCU referred to four relevant supported recommendations from previous review and stated that whilst, on its face, it would likely assist in protecting people from HIV, these recommendations were too broad to ensure any meaningful implementation.
Para 44) Referring to relevant supported recommendations from the previous review, JS2 stated that the HIV/AIDS response had been hampered by an unusable supply of health commodities, particularly condoms and HIV test kits, and considered the recommendations to have not been fully implemented. BCU considered these recommendations to have been implemented in part.
Para 45) BCU stated that Botswana had achieved the “95-95-95” targets, but that there remained a gap in awareness of HIV status, especially among young adults, particularly among young women.51 It stated that education was required to tackle stigmatization related to HIV and sex work, which would ensure the wide use of self-testing.
Para 46) JS4 stated that sex workers were considered a key population in the HIV/AIDS response and the Government had worked with sex worker organizations and their partners to implement projects aimed at linking sex workers to with health care services. However, there was still a service delivery gap, with majority of female sex workers having never been tested for HIV. Stigma and discrimination against sex workers had affected their ability to access HIV testing and other services, with sex workers routinely experiencing discrimination at the hands of health workers.
Para 47) BCU stated that Botswana should abide by the International Guidelines on HIV/AIDS and Human Rights, which were published by OHCHR and UNAIDS to ensure that Member States were implementing international human rights standards on HIV.
Para 34) The Special Rapporteur on minority issues noted that information and communication activities, in particular awareness-raising campaigns regarding important health issues, such as HIV/AIDS, should not be exclusively in Setswana or English.