Botswana: Civil Society & Private Sector response on HIV/AIDS

1. Botswana:Civil Society & Private Sector response on HIV/AIDS XVI International AIDS Conference Toronto, Canada Daniel Motsatsing Executive Secretary BONASO Kabelo Ebineng Chairman BBCA

2. Context for Action • Situation • HIV/AIDS was having huge adverse effects on Botswana’s socio-economic and political development (potential to negate population growth and productivity among economically active age groups (15 - 49) • HIV/AIDS was initially seen as a Medical & Health Sector challenge requiring a medical response (1990’s & Medium Term Plan – MTP I) • Concern • The Government of Botswana enacted policies, initiated programs in a bid to facilitate impact mitigation strategies, however response was minimal –programme review indicated that some sectors were excluded from the response. • Breakthrough Thinking (Question) • How can business sector and civil society organizations be active partners, coordinate interventions and assist grassroots communities, employees, Government, and general population in HIV prevention and mitigating the impact of HIV/AIDS? • Answer • By becoming key partners and being actively involved in a Multi-Sectoral response (Gov’t, private sector, civil society, development partners & Community), so as to complement Government’s efforts in national coordination and collective formulation of workable and sustainable solutions.

3. Actors • Botswana Business Coalition on AIDS (BBCA) • BBCA was established in 1994 & currently registered under the Societies’ Act • Memorandum of Understanding signed between BBCA, BOCCIM and Global Business Coalition on HIV/AIDS (GBC), in 2002 • Strategic objectives: • To assist the private sector in developing HIV/AIDS workplace policies & programmes; • To support the private sector in accessing existing government HIV/AIDS services; and • To assist the government and partners in reaching more people and increasing uptake levels for its services. e.g. ARV treatment programme • Civil Society Organizations (CSOs) • Initial response of CSO to HIV/AIDS was ad-hoc and uncoordinated. • Seen as a major gap: CSO mobilised to regroup and institute national network whose Mission then became “To facilitate a coordinated community response and support AIDS service organisations in the fight against HIV/AIDS” • Botswana Network of AIDS Service Organizations (BONASO) • BONASO was registered in 1997 as a national network • Its mandate is to coordinate and facilitate the response of civil society to HIV/AIDS, through Capacity Building, Information Dissemination and Networking, Resource Mobilisation, Advocacy and Lobbying thereby strengthening interventions and promoting solidarity among the members. • Within the context of the Medium Term Plan II & National Strategic Framework (2003-2009)

4. Action BBCA Initiatives • Public- Private Partnerships • Provision of ART starting early 1990s and training of health personnel for HIV/AIDS early mid-1990s (AFA/Debswana) • Based on their track record and their governance capabilities, these organizations can play an expanded role, which should further exploit the skills and systems they have built-up over time, i.e. ART Provision • Capacity building • In recognition of the existence of policy as a key step in the development and implementation of comprehensive and effective workplace HIV/AIDS programmes, BBCA primarily focuses on assisting businesses; • HIV/AIDS Workplace training: Strategic Management of HIV/AIDS; Peer Education and Counselling; Training of Trainers • Tools: HIV/AIDS workplace toolkit; Manual development; Information Educational Communication (IEC) materials

5. Action – cont’d • Red Ribbon Business Excellence Awards • Establishment of Red Ribbon Awards in 2005, with the dual object of promoting; • HIV/AIDS monitoring and evaluation (M&E) efforts, within the private sector, with a view to integrating these into national considerations and policy actions; • Sharing of lessons and ideas on how to best mitigate the adversity of HIV/AIDS -- particularly in the workplace • The awards recognised and honoured in total 13 small, medium and large companies, which demonstrated good business practices on HIV/AIDS • Advocacy • Business Sensitization Seminars; • Hosting of business leadership seminar in Gaborone, Maun, Kasane, Francistown & Selebi Phikwe • The African Centre for HIV & AIDS Management (ACHAM)/African Think Tank on AIDS Management (ATTAM) • Expert participation in an initiative of Nigerian President Olusegun Obasanjo, under the auspices of the African Union (AU) • The mission of ACHAM, which is based in Abuja, is to strengthen regional management capacity in HIV and AIDS through training which promotes increased coordination in the AIDS response

6. Action – cont’d BONASO Initiatives • Capacity Building • Mobilization of resources for training – Entrepreneurship Skills for PLWHAs • Trainings in Project Mgmt, financial mgmt, M & E and Governance – Global Fund • Gender, Leadership and HIV initiative with UNIFEM and SANASO support • Cyber training and Resource Centre development with SafAIDS • Volunteer human capital input through Canada’s Coady International institute, World University Services of Canada, Peace Corp project etc • New initiative with Africaso/ICASO - Up-scaling Prevention alongside Treatment • Policy Influence & Advocacy • Represents members in different fora, including National AIDS Council • Ensures civil society input into national documents: National Strategic Framework, UNGASS Report, Millennium Development Goals etc. • Planning meetings with Gov’t, Dev’t partners and sister networks • Information Dissemination & Networking • Production of IEC materials like Quarterly Newsletter, Annual report, Brochures, Videos. • Collect, collate and disseminate best working interventions experienced locally and elsewhere • Development and management of website and e-mail facilities and support to members • Operational Cyber Café for CSOs and Regional HIV/AIDS Resource Centre

7. Action – cont’d • Resource Mobilisation • Partnership project with Japan International Cooperation Agency (JICA) for IEC equipment • GFATM Seed Grants for Income Generation Activities (IGAs) by PLWHAs, CBOs/NGOs. • CBO/NGO Income Generating Projects focusing on actively engaging PLWAs support groups and OVCs in small scale micro – economic enterprises – minimal cost recovery strategy and sustaining communal momentum (volunteerism). • Small Grants Project to develop capacity of emerging organisations with less chances of getting funding elsewhere • Connecting Communities Project to partner with expertise of university personnel at little or no cost • Other Sister Networks – Comprehensive Civil Society Response • Botswana Christian AIDS Intervention Programme (BOCAIP) mobilises the response of the faith based sector for program development-orphan care, counseling etc • Botswana Network of People Living with HIV/AIDS (BONEPWA+) mobilises groups of people living with HIV/AIDS, for care, support and treatment as well as building capacity & partnership development plus stigma reduction initiatives • Botswana Network on Ethics, Law and HIV/AIDS for addressing legal & ethical challenges of PLWAs, workplace discrimination, review of the legal environment and provision of legal capacity

8. Action – cont’d • CBOs & NGOs implement programme activities, which focus on; • Community Mobilization, Education and up scaling prevention through Behaviour Change Information Communication (BCIC) projects • Support, Care and Treatment including Counselling and Testing services • Socio-Economic Impact Mitigation (Design and Implementation of Income-Generating projects especially for People Living with AIDS (PLWHAs), Orphan and Vulnerable Children (OVCs) • Capacity Building and Institutional Strengthening (operational space, human capital and program management) • Policy, Advocacy, Social research & ethical and legal issues (Review of laws & policies - protecting Human Rights of PLWAs, Sex workers and other vulnerable groups)

9. Strategic challenges of the response effort • Organizational/Institutional Level • Lack of adequate office space, appropriate equipment and infrastructure (constrained working space) • Limited human resource capacity and lack of requisite, technical skills • Constrained (narrow) funding base (Botswana: upper-middle income economy • Challenge of sustaining projects on the ground for a longer period • Lack of own fund-raising & sustainability strategies • Difficulty of networks to maintain a close contact with an increasing membership base but with limited support • Sector/Grassroots Level Based on a Needs Assessment Survey conducted in 2004; • Only 18% of the surveyed companies had HIV/AIDS policies. Fewer small companies had policies than large or medium sized companies. (Not many companies have mainstreamed HIV/AIDS into their corporate strategies) • In those companies that had policies, awareness of the existence of such policies was lower among employees, compared to managers. • Inability to reach SMMEs and the lack of technical and financial capacity to implement workplace programmes • Poor uptake / utilization of company sponsored HIV/AIDS services by employees. e.g. V.CT.

10. CSO & BBCA Programme Impact on Target Communities • Reduction in burden of care from health officials • Notable behavior change within the general population, in particular a more caring attitude towards people living with HIV/AIDS • Generally, increased focus on developing HIV/AIDS programmes within the workplace in the private sector in achievement of the NSF objectives • Greater use of external HIV/AIDS programme services • Counseling & referral services established/supported • Support to utilization of national programmes and community services realized • Contributes to poverty alleviation activities and improved nutrition to the clients (IGAs) • Seed funding for innovative grassroots projects (IGAs), built capacity built at local level and engaged PLWAs support groups productively.

11. Conclusion & Focus Areas • Prevention, treatment care and support efforts can be greatly enhanced; • Optimizing private sector capacity • Strengthen and Expand service delivery by CSOs, replicating best practices and sustaining HIV/AIDS projects initially funded on short – term (maintaining momentum at community level) • Civil Society involvement in VCT and ARV program roll out campaign and supportive counseling provision Assisting CSOs and BBCA to play a significant role in community preparedness and adherence to treatment • Promote efforts on balancing prevention activities with care, support and treatment initiatives • Establish community resource centers (prevention, care & support, education & counseling) • Greater logistical and technical support between Development Partners, Government, Civil Society and Private Sector • Greater utilization of Supply Chain Programming – mentorship between the larger and small, medium and micro-enterprises • Empower CSOs on resource mobilization skills, project development, reporting & financial management and governance. • Capacitate CBOS/NGOs on Social research, documentation and dissemination. • Targeted intervention and rights based approach to program design (optimize impact)