Mary Banda – not her real name – is a 35-year-old HIV positive sex worker from neighboring Zambia who cannot afford life-prolonging anti-retroviral drugs.
Like many sex workers living with HIV in Botswana, she also cannot afford to travel back home to receive free treatment.
That is why Banda welcomes legislation before the Botswana cabinet that, if passed, would provide free ARVs to HIV positive foreigners.
“If they do that it will be a good idea because some of us are dying here,” she said. “Maybe someone will be getting (the) tablets back home, and when they get finished, they don’t have money to go back and take the tablets.”
Banda says a number of sex workers she knew in Botswana have died from AIDS-related illnesses due to lack of treatment.
Immigrants and sex workers in Botswana afflicted with the HIV virus that causes AIDS could get a lifeline as the southern African country is due to decide on offering free Anti-Retroviral (ARV) treatment to foreigners. An estimated 30,000 migrants have HIV in Botswana, which has the third highest HIV prevalence in the world. Experts say refusing to offer free ARV treatment is making it harder for Botswana to eradicate the virus.
Tosh Beka, who is head of the sex worker rights group Sisonke, says Botswana has about 1,500 foreign sex workers in need of ARV treatment.
“If they are infected and are not getting any help and we are saying we want zero infections, then it means we are doing nothing,” he said.
Botswana’s has an estimated 30,000 HIV positive foreigners but only 7,000 are getting treatment, according to the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR).
PEPFAR coordinator Dan Craun-Selka says the agency supports offering free ARVs for all and has pledged to provide funding to Botswana.
“Once the government changes this policy, it will help bring about epidemic controls in this country,” he said. “That is something that really needs to take place. We have discussed this with ministries and it’s now with the cabinet for their decision.”
Botswana became the first country in southern Africa to provide free ARV treatment to HIV positive citizens.
The measure has been partially credited with reducing Botswana’s high rate of HIV infection from 25 percent of the population down to 21 percent.
But Botswana still has the third highest HIV prevalence in the world, after Lesotho and eSwatini.
National AIDS Coordinating Agency director Richard Matlhare says free treatment for HIV positive foreigners would further reduce the virus’s spread.
“We must look at the overall bigger picture of ending AIDS and not leaving anyone behind,” he said. “On the other hand, we must look at the prevailing policies on the ground, and the cabinet must make a determination.”
Botswana’s cabinet is expected to make a decision before the country holds general elections in October.