Sustainable Development: The UN Millennium Development Goals, the UN Global Compact, and the Common Good

2. A Public and Private Partnership: The ACHAP Experience in Botswana

52 2 | A Public and Private Partnership: The ACHAP Experience in Botswana Themba L Moeti, Innocent Chingombe, and Godfrey Musuka hIV/AIDS is one of the greatest threats to development for African countries, particularly those in southern Africa, where Botswana is located. hIV/AIDS is acknowledged as Botswana’s greatest health and development challenge. Thus, dealing aggressively with hIV/AIDS and its consequences has the potential to result in significant progress toward the attainment of key Millennium Development Goals (MDGs). hIV/AIDS causes mortality among the population of both adults and children, and negatively affects maternal and child health. It also makes communities more vulnerable to another major disease, tuberculosis. hIV has also increased the vulnerability of the population to poverty and hunger through reduced incomes and increased dependency ratios, as breadwinners become sick and die. This chapter seeks to illustrate Merck’s corporate social responsibility in health and development and also its commitment to the un Global compact, by highlighting the link between its support to the Government of Botswana’s hIV/AIDS response and progress toward the attainment of the Millennium Development Goals (MDGs) through a unique public-private development partnership with the Government of Botswana and the Bill & Melinda Gates Foundation. A Public and Private Partnership 53 Given that Botswana suffers from one of the most severe hIV/ AIDS epidemics in the world, the high costs of setting up and maintaining its national hIV/AIDS response have negatively affected other development priorities and remain a threat to the government’s capacity to deliver the health and social services essential to improving and sustaining human development. The African comprehensive hIV/AIDS Partnerships (AchAP) is a country-led, public-private development partnership formed in year 2000. It has been active in the country since 2001 as a key player in assisting the Government of Botswana (GoB) to address the scourge of hIV and AIDS, thus contributing to improved human development. As a result of an effective hIV response, Botswana has seen a substantial reduction in mother-to-child transmission and hIV-related mortality for a decade starting in 2001, and it continues to register a reduction in hIV transmission rates. however, important challenges still lie ahead, especially about how best to sustain the gains seen so far. InTRoDucTIon In his foreword to the Millennium Development Goals 2010 report, Dr. Ban ki-moon, the un Secretary-General, stated: “The Millennium Declaration in 2000 was a milestone in international cooperation, inspiring development efforts that have improved the lives of hundreds of millions of people around the world. The Goals represent human needs and basic rights that every individual around the world should be able to enjoy—freedom from extreme poverty and hunger; quality education, productive and decent employment, good health and shelter ; the right of women to give birth without risking their lives; and a world where environmental sustainability is a priority, and women and men live in equality.” Botswana is one of 189 countries that made a commitment to the eight ambitious MDG targets, which provide a framework and roadmap for time-bound and measurable goals to be reached by 2015. The year 2011 marks a decade of Botswana’s commitment to this declaration, and coincidentally also ten years since the establishment of the African comprehensive hIV/AIDS Partnerships. 54 Themba L Moeti, Innocent Chingombe, and Godfrey Musuka AchAP was established to help the GoB address the hIV/AIDS epidemic and its associated development challenges through a comprehensive approach across the spectrum of prevention, treatment, care, and support. The total grant commitment from the Bill & Melinda Gates Foundation and the Merck Foundation for the period between 2001 and the end of 2009 totaled uSD 106.5 million. In addition, Merck donated two antiretroviral medicines, cRIXIVAn® (Indinavir ) and STocRIn® (efavirenz), for use in the national antiretroviral (ARV) treatment program for the duration of the partnership. In 2008, it added two more medicines to its donation, namely, InSenTReSS (Raltegravir) and ATRIPLA (efavirenz Tenofovir emtricitabine). The two foundations have now made a commitment for a second phase of support totaling about uS$60 million for the period 2010–2014, and the Merck medicines donation will also continue to 2014. In this essay we describe how this unique partnership, aimed at addressing one of the most severe hIV/AIDS epidemics globally, has, in turn, made important contributions toward the attainment of several of the country’s MDGs. notable MDGs for Botswana that...