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Botswana's Gains Against AIDS Put U.S. Claims to Test
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The message he received from the health officials, Kilmarx said, was that while they had been unhappy with some of the Bush program's characterizations, they wanted the funding to keep coming.
In subsequent phone interviews, both Mazonde and Ramotlhwa softened their tone, emphasizing their gratitude for the millions of dollars that, they said, they still expected from the Bush program. Ramotlhwa suggested it was better to say the Bush numbers exhibited "some element of distortion" rather than characterizing them as "a gross misrepresentation of the facts."
Yet when asked if there was anyone whose antiretroviral treatment was dependent on the Bush program, Ramotlhwa and Mazonde said they knew of none.
"We cannot single out a person who would not be receiving treatment," Mazonde said.
On June 13 -- two weeks after that interview -- Bush announced new totals for his AIDS program. They were ahead of schedule, reaching more than 200,000 people with U.S.-supported treatment in the 15 developing countries the program focused on.
In backup documents distributed by U.S. officials, the treatment total for Botswana was neither the 32,839 cited in January nor the 41,444 that Kilmarx submitted to his superiors in May. The new total, offered with no explanation, was 20,000.
Asked about the shift, the Bush program's deputy coordinator, Mark R. Dybul, said in an interview at his Washington office that reporting systems were evolving. "We're changing the numbers as we refine reporting," Dybul said. Of the Botswana health officials, Dybul added, "They saw what's in here and they cleared it."
He also disputed Kilmarx's statement that minor assistance, such as revising an official's speech, would allow the Bush program to claim it had supported treatment for everyone receiving it in a country. The new totals, Dybul said, included only those receiving "significant support," meaning that "these people would not have quality treatment, would not have substantial services, without the U.S. government."
In a final phone interview, Mazonde again expressed gratitude for the U.S. aid. He added that a series of conversations with U.S. officials in recent weeks had impressed on him the many ways that the Bush program funding was assisting Botswana, and that several million dollars promised for the national treatment program would soon be available.
But when pressed, Mazonde said there were not 20,000 people in Botswana whose "quality treatment" was dependent on the U.S. government. In fact, he said, there were none.
