While there is talk of ending AIDS, tensions have grown regarding donors reducing funding. How do you navigate this?
DM: I think first of all it’s getting your story and contextualising it in economic terms. Because you must be able to show, this is what it’s costing me now and you cannot just look at HIV/AIDS, you must look at all the relatives of HIV and AIDS. You must look at how much you are spending on TB, how much you are spending on STDs, how much you are spending on all these other diseases that are associated with HIV and AIDS.
How much you are losing in terms of productivity and the minute you start doing that, it will show you that you don’t have any choice but to basically confront this issue now. I think it’s about time that each and every health minister looks at sustainability as part of the modelling of any approach or any initiative.
Secondly, I think we must continue to argue. Botswana as you know, is now a middle-income country. I’ve argued forcefully that my disease burden matters to me. Therefore if I go and ask for funding and ask for partners to come in, they cannot just talk about my GDP per capita income and stuff like that, they must also look at the challenges that I am faced with.
I think the fact that so far we have put in more than 60 percent of our funding for HIV and AIDS, the fact that the government of Botswana has surpassed the Abuja Declaration of spending 17 percent on the health budget. Surely there must be partners out there that will say, “This country is doing the best that it can, we want to be associated with the success that will come with that boldness and the resolve.”
Is Botswana still looking for partners. Can you afford it on your own?
DM: No, we cannot afford it on our own I can tell you now. Even as a middle income country, I had a funding gap of about US $15.6 million and I had to go to the US and say, “Look do you want to help me or not?” Well I didn’t put it that way. I was much nicer, and they did.
Which demographic remains the most vulnerable to HIV in Botswana?
DM: The youth, the girl child, in particular, that is where all our energies must be. For me, if you say key population there is this whole debate of key population being confined to what others want it to be.
I must focus on is the youth, because they are the leaders of tomorrow. They are the ones that are going to live much longer than us and we have to intensify our efforts and make sure that whatever our efforts are, our initiatives are, we are listening to the voice of the youth, we’re in alignment with what works for them.
We can’t prescribe for them, we can’t think for them, so they must be included in this transition, but they must be at the core of the strategy.