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Botswana's dry conditions
REFERENCES
would sometimes hide their own status from their children, even
though vertical transmission had occurred.
The public hospital behind our clinic was overrun by monkeys
leaping from one garbage can to the next, yet it was quite impressive
compared with public hospitals in Tanzania. I admitted a patient with
TB pericarditis, and he was able to access life-saving pericardiocentesis
at this facility. Yet there were less resources in rural areas, where
our team would consult on patients with viral failure while training
HIV providers. These sites had less options for ART as well as no
available resistance tests and issues with CD4 results taking over one
year to return.
The heavy burden of HIV in Africa can be seen with a glimpse into
care in these two countries. Tanzania-and similar nations-have
faced the highest hurdles to quality HIV care given their deep poverty
and paucity of treatment resources. Yet nations in sub-Saharan
Africa have overcome many challenges, as is evident in Botswana.
These countries are generally moving the needle in the right direction
regarding HIV care. Therefore, there is reason to have much hope for
HIV care among the kind and hard-working people of this beautiful
continent. HIV
KIRK SCIRTO, MD, MPH, FAAFP, AAHIVS is a family physician
and HIV specialist who has studied tropical medicine extensively. He
has spent much of his career volunteering and working in various
resource-limited nations in sub-Saharan Africa, Southeast Asia, Latin
America, and the Caribbean. He has cared for people with HIV in
Uganda, Tanzania, Botswana, and the United States.
1. Tanzania Commission for AIDS (TACAIDS) and Zanzibar
AIDS Commission (ZAC). Tanzania HIV Impact Survey
2016-2017: Final Report. 2018. Dar es Salaam, Tanzania:
TACAIDS and ZAC.
2. Id.
3. Joint United Nations Programme on HIV/AIDS. United
Republic of Tanzania. 2021. Retrieved from https://www.
unaids.org/en/regionscountries/countries/
unitedrepublicoftanzania
4. Tanzania Ministry of Health, Community Development,
Gender, Elderly and Children (MoH, C, D, G, E, & C).
National Guidelines for the Management of HIV and AIDS.
7th Ed. 2019. Dar es Salaam, Tanzania: MoH, C, D, G, E, & C
& National AIDS Control Programme.
5. World Health Organization (WHO). Consolidated
Guidelines on the Use of Antiretroviral Drugs for Treating
and Preventing HIV Infection: Recommendations for a Public
Health Approach. 2nd Ed. 2016. Geneva, Switzerland: WHO.
6. Id.
7. Tanzania Ministry of Health, Community Development,
Gender, Elderly and Children (MoH, C, D, G, E, & C).
National Guidelines for the Management of HIV and AIDS.
6th Ed. 2017. Dar es Salaam, Tanzania: MoH, C, D, G, E, & C
& National AIDS Control Programme.
8. Joint United Nations Programme on HIV/AIDS. Botswana.
2021. Retrieved from https://www.unaids.org/en/
regionscountries/countries/botswana
9. Farahani M, et al. Outcomes of the Botswana national HIV/
AIDS treatment programme from 2002 to 2010: a
longitudinal analysis. Lancet Global Health 2014; 2(1): e44-50.
10. Maipose, G. Botswana: the African success story. In The Politics
of Aid: African Strategy for Dealing with Donors. Ed. Whitfield,
L. 2009. Oxford, UK: Oxford University Press: 106-130.
11. Joint United Nations Programme on HIV/AIDS. Botswana.
2021. Retrieved from https://www.unaids.org/en/
regionscountries/countries/botswana
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HIV Specialist - June 2021

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