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2005-09-16-Taking the Aids battle forward
As the UN finishes its anti-poverty summit, the BBC News website assesses how Africa could meet the Millennium Goals in 10 years' time. Here, Mohammed Allie visits Swaziland and Botswana - both badly affected by HIV/Aids - and compares their efforts in tackling the epidemic.
"They've performed a miracle with my kid," says Kefilwe Mothei.
Kefilwe, who is HIV positive, has seen the tremendous impact of the Botswana-Baylor Children's Clinical Centre of Excellence in Gaborone, the capital of Botswana.
She says that thanks to the centre's timely intervention, her baby Jennifer, who tested positive as a two-week-old infant, has now developed into a healthy four-year-old.
Amid the stigma surrounding HIV-Aids and the resultant reluctance of people to go for voluntary testing, the success of the Botswana-Baylor Centre in treating infected children has encouraged an increasing number of parents to have themselves and their offspring tested.
The product of a partnership between the Botswana government and an American pharmaceutical company together with Baylor University, the centre is the first of its kind on the African continent.
It provides state-of-the-art care and treatment to more than 1,000 HIV-positive children and more than 200 families from surrounding areas.
"We have many people who come in and say that they were afraid to have their child tested for HIV," says Dr Liz Lowenthal, a paediatrician who is the assistant director of the centre.
"But then they have a neighbour or a friend whose child was very ill and received treatment here and is now healthy."
Thanks to partnerships with international agencies, Botswana has been relatively successful in dispensing anti-retroviral drugs to an increasing number of people who are making use of voluntary counselling and testing facilities throughout the country.
But despite this success, Dan Motsasing, executive secretary of the Botswana Network of Aids Service Organisations (Bonaso), believes there needs to be a greater focus on preventing Aids transmission in the first place.
"At the end of the day prevention is the key, but I think there's still a lot of ground work that needs to be done because the organisations, for example, in the country that are working on prevention have not gotten the support that they should get."
Driving around the streets of Gaborone one cannot help but notice the huge Aids awareness billboards strategically placed along the roadside at regular intervals.
There's also a regular radio talk show, and the authorities have invested in producing a number of educational videos to spread the message.
This is in contrast to the situation in Swaziland, where billboards are sparse and information about HIV/Aids not as readily available as it should be.
"Knowledge is powerful, sound decision making, so if people are being given the knowledge they'll be able to change their behaviour," says Hannie Dlamini, secretary general of the Swaziland Aids Support Organisation.
"So the problem we have now, is that the knowledge is not much and people have a lot of doubts."
Targeting the young
Swaziland, with its infection rate of 42.6% according to the country's Department of Health, has overtaken Botswana, which has an estimated infection rate of 37.4%.
Nevertheless, the Swazi health authorities have been encouraged by the decrease in prevalence among the youth.
Department of Health figures indicate that HIV prevalence among youth aged between 15 to 19 years declined from 32.5% in 2002 to 29.3% in 2004.
The optimism is further enhanced by a decline in teenage pregnancies from 30 % to 24%, which appears to indicate that youth are either abstaining or practising safe sex.
"We've told these young people how important they are," says Colin Ngwenya, a spokesman for the Asibambisani Anti-Aids and Cultural Group, who use dancing, poetry and drama to tell their peers about the disease.
"Swaziland is a small country and being a small country if we have an irresponsible youth then we don't have a country at all."
Creating awareness about HIV/Aids among the youth is also a major priority in Botswana.
"For the future what we will be emphasising is equipping especially youth with skills and knowledge, making sure that the environment within which they live - the communities and families - are supportive to achieve that desired behaviour change," Monica Tselayakgosi, programme planning manager of the National Aids Co-ordinating Agency (Naca), explains.
It's commonly accepted that women often bear the brunt of the Aids pandemic in Africa - and traditional polygamy makes it worse, says Africa Magongo, a trade unionist working in Swaziland's Ministry of Health.
"It is a culture in Swaziland to say that one man can have many wives, but the question is, is it OK with the situation as it is on HIV-Aids to continue with that culture?" he asks.
"Is it OK for the country's leaders to engage in such a culture as role models?"
There are numerous other issues such as the loss of qualified medical personnel to other countries, inadequate health budgets and the slow pace of behaviour change which impact on the ability of countries like Botswana and Swaziland to meet the Millennium Development Goal of no new infections by the year 2016.
Still, Monica Tselayakgosi is optimistic that the battle against Aids can eventually be won.
"I think it's always good to have a target towards which you want to move," she says.
"But maybe in terms of absolutely no new infections, maybe it will take a while longer."