Country Highlights

Since the first identified case of HIV/AIDS in Botswana in 1985, the spread of the virus in the population has been explosive. However, in 2002, Botswana was one of the first countries in Africa to establish a national HIV/AIDS treatment program. By September 2004, Botswana had already achieved the WHO "3" by "5" target of 30,000 people receiving treatment by the end of 2005 (based on 50 percent of the WHO/UNAIDS estimated need in 2003). Currently more than 100,000 are on treatment.

The government of Botswana has declared HIV/AIDS a national emergency and is committed to an aggressive, comprehensive, and expanded multisectoral response to curb its impact on society. To that end, the government has adopted a compelling, long-term vision to have no new HIV infections by 2016. SCMS aids the government's effort through technical assistance to the Central Medical Stores (CMS), the Drug Regulatory Unit (DRU), PMTCT Programme and Laboratory Services to strengthen the supply chain system for antiretroviral (ARV) medications, Infant formula and HIV test kits and laboratory commodities.

Our key objectives in Botswana are:

• Information sharing: We promote strategic information management to ensure required tracking of ARVs and other HIV related commodities
• Capacity Building in HIV/AIDS treatment and laboratory infrastructure: We provide technical assistance and support to the Ministry of Health and other agencies.
• Procurement and distribution: We put in place mechanisms for timely procurement and supply planning of laboratory supplies, reagents and equipment.

Value of commodities delivered as of June 2008: Over USD $2.9 million

Progress to date:

Until recently, the country had purchased only branded ARVs for HIV/AIDS patients who receive free health care from the government. However, due to high costs, the government would like to switch to more affordable generic medications. SCMS is partnering with the DRU to streamline the drug regulatory process within the Ministry of Health and provide safe, effective generic alternatives as soon as possible. Technical assistance provided has enabled reduction of dossier review backlog and strengthening ARV (and other commodities) registration systems including installation of an updated version of WHO recommended software for drug registration (SIAMED).

In September 2007, SCMS provided training in ARV quantification and demand planning to staff of the CMS, Ministry of Health and Ministry of Local Governments. The county's first forecast for HIV/AIDS medicines resulted from the training and will help plan future resource needs and purchases. In February 2008, SCMS supported the ARV team at the CMS to produce a five-year forecast that will guide the Ministry of Health in mobilizing resources for the next National Development Plan period.

One of the biggest challenges facing HIV/AIDS treatment programs in Botswana is delayed and missing test results and/or specimens. This has resulted in delays in initiating treatment for people testing positive for HIV and in monitoring patients already on treatment. In 2007, SCMS conducted an assessment of laboratory supply chains, culminating in October with a stakeholder's workshop with 48 representatives of the government of Botswana and its key partners in HIV/AIDS treatment, including chief medical officers in charge of the hospitals and heads of laboratories. An important first step in addressing systemic problems in laboratory supply chains, the workshop helped stakeholders develop recommendations to address problems found during the assessment, commit to an implementation plan and, where possible, provide necessary resources.

In March 2008, SCMS helped produce the first national laboratory commodity quantification, a 12-month quantification of laboratory reagents and supplies to provide the basis for planning national laboratory commodity requirements. The quantification is an important step in providing reliable supplies of laboratory commodities.

This year, a Quality Management System (QMS) methodology was commissioned as a suitable approach towards addressing challenges experienced by Central Medical Stores, with the aim of put in place system that promote sustainable availability of commodities.