Botswana

Health workers listen during the Mahalapye Hospital staff meeting, Botswana. {Photo credit: MSH/}Photo credit: MSH/

“J’mappelle Mompati. Comment t’appelles tu?”

Overcoming my confusion at being greeted by a French-speaking man in Botswana, I smile, take his proffered hand and reply in my rusty, stilted French, “J’mappelle Naume...”

Mompati is Mahalapye Hospital’s dynamic public relations officer. Now that he has my full attention, Mompati wastes no time in telling me about his work linking the hospital and the surrounding community through events and the media. We exchange contacts and he hands me a few copies of his newsletter before dashing off to his duties.

Mahalapye is a small town in the Central District of Botswana on the edge of the Kalahari Desert. Situated along the main road between the capital, Gaborone, and the second largest city, Francistown, Mahalapye is a convenient stopover place.

The hospital has been recently renovated and serves 300 outpatients a day and up to 200 inpatients.

Luanda, Angola. {Photo credit: MSH.}Photo credit: MSH.

I am in Luanda, Angola right now, and what an interesting place. It is the most expensive city in the world: a can of coke costs $5, a car and driver for the day costs between $250-$300, and a basic hotel room with a view of people living in shacks below and cranes building more skyscrapers above is $380 (and it is difficult to find it for less).

Luanda feels like Africa mixed with Latin American and European energy and music. The traffic is bumper to bumper. It is not possible to have more than two meetings in a day because it takes that long to get from one area to another in the city. But it feels calm. Drivers in Luanda have figured out how to navigate the maze...slowly weaving in and out, letting a car in as they make a two lane road into three, and double parking with half the car on the sidewalk. Hardly anyone honks, it is hot and slow, and it feels like there is a sense of order to the chaos.

Angola is a country that has tremendous wealth, primarily derived from oil and other minerals. That wealth is controlled by an elite few, and there are wide disparities between the rich and the poor; 54% of the population lives on less than $1.25 a day. The public health challenges in Angola are significant. The under-five mortality rate in 2010 was 161/1,000 births, and the maternal mortality rate is 610 per 100,000 live births.

The 16th International Conference on AIDS and Sexually Transmitted Infections (ICASA) opened today, December 5, 2011, at the newly refurbished Millennium Hall in Addis Ababa, Ethiopia, with a colorful and lively music and dance production by the Ethiopian National Theatre and Traditional Music Group and the Addis Ababa Youth & Children’s Theatre.

UNAIDS Executive Director Michel Sidibé at the 16th International Conference on AIDS and STIs in Africa (ICASA). Credit: UNAIDS/J.Ose.

UNAIDS Executive Director Michel Sidibé gave an impassioned welcome speech remembering the last 30 years of AIDS and the 24 million African lives lost to the epidemic. He called for solidarity and compassion for the 34 million people currently living with HIV.

Monday at the International AIDS Society conference in Rome, an expanded session featured information on the HPTN 052 study, the Partners PrEP Study, and the Centers for Disease Control’s TDF2 study presented in a joint session titled Treatment Is Prevention: The Proof Is Here, on Monday. The results of these trials will fundamentally change the way we think about HIV prevention and treatment, although implementation of these approaches will likely prove as challenging as ever.

HPTN 052, sponsored by the HIV Prevention Trials Network, was the first randomized clinical trial to definitively indicate that an HIV-infected individual can reduce sexual transmission of HIV to an uninfected partner by beginning antiretroviral therapy sooner. The study involved 1,763 HIV-serodiscordant couples at 13 sites across Africa, Asia, and the Americas. The trial results were initially released in May 2011 on the recommendation of an independent data and safety monitoring board (DSMB) and Monday’s session was the first full presentation of the trial data.

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