Here's the abstract of the seminar I'm attending:
Through its development as an independent nation over the past 45 years, Botswana has been a leader among African nations in designing effective and thoughtful public health policy. Proactive efforts by the government, particularly the Ministry of Health to provide pioneering treatments, research, and education to its people is inspirational and sets the country apart as a model of success in the public health realm. However, in the face of these efforts lie great challenges. The HIV/AIDS pandemic has hit Botswana hard, and this seminar will look at how the scourge has had devastating effects on every corner of society. Aside from HIV/AIDS, which is arguably Botswana’s most pressing public health threat, other dimensions of the public health story will be explored including women’s health issues, healthcare delivery in rural and urban settings, traditional and modern approaches to medicine, and mental health in an African context. Seminar participants will see and learn about these topics through socio-cultural, political, economic, and environmental paradigms, with a special emphasis on poverty as a barrier to public health. In a broader view, participants will gain a holistic understanding and appreciation of some of the issues that developing nations face in their efforts to provide sustainable public healthcare.
Botswana has one of the world's highest adult HIV/AIDS prevalence rates, with about 24.80%!-(MISSING)49 years old affected (about 1 in 4 people). It shares this unfortunate status with Swaziland and Lesotho. To put this in context, the US rate is 0.60. These are 2009 numbers.
Stats tend to run a couple of years behind. The source for these is the CIA World Factbook.
The good news, according to UNAIDS
, is that the rate for 15-24 year-olds is dropping.
There's a great deal of disagreement about which interventions are effective and in which cultural and sociopolitical contexts. HIV is a slow virus, making it is hard to evaluate its spread and effective interventions. Diseases like Ebola or smallpox are easier to understand because their effects are more immediate.
Current speculation about factors affecting the spread of HIV in Africa include concurrent partnerships, transactional sex, and circumcision status. All of these are both asserted and contested. The effects of poverty and strife are not clear, and the effects of condom and abstinence promotion ambiguous. "Zero grazing," which was a campaign to discourage extramarital relationships, may have been helpful, and it may not have been. I'm looking forward to hearing from Batswana themselves. (This is the name for the people; Bo
tswana is the country.)
Today's transit leaves Oregon in the evening. An overnight flight takes me to New York, and tomorrow I fly from New York to Johannesburg, South Africa and then to Gaborone, Botswana, arriving 6/2.
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