Thirty years on, the cure for HIV/AIDS remains elusive, but researchers from various corners of the world are making enormous efforts and as the quest ensues, one Motswana woman, Dr Catherine Koofhethile, an immunologist, is in the thick of things and among those in the forefront to enhancing HIV/AIDS Cure research, ANGELA MDLALANI writes.
Despite the fact that both the vaccine and cure for the Human Immunodeficiency Virus (HIV) have eluded the researchers’ inquisitive eye for three decades now, Dr. Catherine Koofhethile believes that a breakthrough for an HIV cure is nigh. Having spent almost all her career life in HIV research, Koofhethile is of the strong view that more focus should be placed on cure research.
During her PhD studies, her research focussed more on the understanding of the mechanisms of HIV control during the chronic stage of infection but the turning point was in 2014 when she was nominated to attend the 64th Lindau Nobel Laureate (Medicine and Physiology) meeting in Germany. There, she met and interviewed the esteemed Professor Barré-Sinoussi who received a Nobel Prize for co-discovery of HIV.
“That was big for me, as I was fortunate enough to be meeting this woman who has taken great strides in HIV work. We discussed a variety of topics with regards to HIV research. And when she gave her talk, she encouraged work towards cure research. Her talk motivated me and pushed me to think about having my post-PhD career be focused on cure research.”
Further, she was propelled by revelations by Prof Barre-Sinoussi’s assertion that she had interacted with HIV infected people who had revealed that they were tired of taking medication and wanted to be cured. Today, Koofhethile is based in the United States in Boston, Massachussets at the Harvard T. H. Chan School of Public Health. Under the mentorship of Professor Max Essex and Dr. Vladimir Novitsky, she still researches on HIV.
Prof. Essex is among HIV experts who have been researching on HIV since the beginning of the epidemic. Currently, Koofhethile’s research focuses on understanding the architecture; size and structure of the proviral reservoir in HIV infected individuals undertaking antiretroviral treatment (ART) in Botswana.
She uses a combination of Immunological and Virological assays to monitor proviral reservoir in HIV infected individuals. She works in collaboration with a local Investigator, Dr. Sikhulile Moyo, a Virologist based at Botswana Havard AIDS Institute Partnership (BHP) in Botswana where she also holds a Research Associate position. Here, she is actively involved with research and also mentors and supervises some of the upcoming researchers and students who are attached at the lab.
“When HIV infects the cells, mostly CD4+ T cells, the majority of these infected cells eventually die but only a small proportion go in to a ‘resting state’ creating what we call ‘reservoir’. This is a situation where by the virus can sort of hide in different parts of the body. The reservoir sites can be in tissues such as the lymph nodes and spread across the body including central nervous system and the gastrointestinal track. This reservoir is the major obstacle to finding a cure for HIV,” she revealed.
“My current research therefore is focused on trying to understand this reservoir. In order to completely eradicate the virus from the body, we must eliminate the reservoir but in order to get rid of the reservoir, there is need to understand its dynamics.”
Just last month, Koofhethile flew into the country and gave her first ever Public Lecture at the University of Botswana. And fittingly, it was hosted in her homeland. The Public Lecture addressed her previous PhD and current post doctoral research work, which she revealed to this publication, was going well. She also gave a summary of the current global HIV cure research – an update of where we are in terms of finding a cure.
The public lecture was well attended, including by her family who got to see firsthand the kind of work she does, since she is not based in Botswana. “It was very humbling to see my family and friends in the audience; they have greatly supported me throughout my career. And for them to see my progress meant a lot to me. They now understand the kind of work I am involved in and are very proud.”
The current study, she and Dr. Moyo started last year November will be completed hopefully at the end of this year (2018). The study involves teenagers who were born with HIV, started ART soon after diagnosis and have been on therapy for many years. “It is a very important project that will give us a better understanding of the HIV reservoir and enhance HIV cure research. We are still recruiting for this study but already I am hopeful about it,” she said.
The making of the great Doctor
Koofhethile has almost always known she would end up in science. She grew up at a time when HIV had just been discovered, and the stigma and fear of AIDS was rife. She would go on to hear more about this monstrosity at school, although not much was known about the disease then. So curious was the young Koofhethile that she at that young age took a life decision that she would grow up to one day help end that epidemic.
Fast forward to some years later, now a qualified microbiologist and immunologist, the Harvard Post-doc Fellow is among those at the forefront of the worldwide effort working towards HIV cure research. Right from her primary school days, she had always performed well in Mathematics and Science, it was no surprise then when after the Junior Certificate she went on to do Pure Sciences and Add Maths.
She proceeded to do her Tirelo Sechaba (National Service) at the Botswana National Youth Council as an Admin Assistant and occassional peer educator on HIV/AIDS before proceeding to do her first year at the University of Botswana. She spent only her foundation year (formely known as BSc Part 1) at UB and she was then offered a scholarship for a four-year Bachelor of Science Degree with Honours in Medical Microbiology at the University of Surrey in the United Kingdom.
Upon graduating, she returned home and was offered a job at BHP as a Fogarty Fellow. After 2 years, she decided to go back to read for her Masters Degree in Immunology at the University of Birmingham, still in the UK, albeit this time as a self sponsored student. “My family contributed a lot towards my school fees and upkeep and I’ll forever be grateful for their unconditional support,” said Koofhethile.
All along, she was itching to get her hands on HIV research, but there were no dedicated research projects on HIV. Eventually, after her second degree, she decided to contact a Professor at Oxford University who was only impressed she would want to work with HIV research. The Professor in question is Phillip Goulder, whose work has had a major impact in the field of HIV research throughout the world. A renowned paediatrician and researcher, he is lauded for his great contributions towards HIV research.
Dr. Koofhethile spent 2 and half years at Prof. Goulder’s lab, working as a Graduate Research Assistant. “My time at the Goulder lab was fulfilling in many ways. Most of my research techniques I employ in my HIV research were learnt from the Goulder lab,” she said in an interview. She would want to continue studying under Goulder’s mentorship, but this time in Africa, at the “at the epi-centre of the epidemic”.
“During my time at Oxford, I already knew I wanted to proceed to a PhD and that I wanted to study in South Africa under the mentorship of both Prof. Goulder and Prof. Thumbi Ndung’u who used to work in Botswana. And I knew both professors would be fantastic mentors since they are experts in the field of HIV research.” In 1998, Goulder and some colleagues founded a state-of-the-art lab at the University of Kwazulu Natal (UKZN), in Durban South Africa, the university Koofhethile had in mind for her PhD.
“It really made sense for me to study in Africa than elsewhere because we are the hardest hit by HIV. When at home, you get to experience how people affected relate with the research,” she highlighted further. So, she decided to take up her studies, focusing on the Immunology of HIV. “I was basically trying to understand why some people get infected and do not fall sick and while some get infected and their health deteriorates very fast.”
Her PhD research entitled “Protective HLA Class I Alleles: Investigation of Viral Control and Lack of Control in Chronic HIV-1 Subtype C infection,” in fact, has brought scientists a step closer to understanding the phenomenon whereby a rare group of individuals control HIV-1 infection without antiretroviral therapy.
Her PhD studies were supported through scholarship from the Organisation for Women in Science for the Developing World (OWSD) and partly by some of Prof. Ndung’u’s grants. The OWSD is a non-profit making entity whose objective is to strengthen women scientists’ role in the development process and promoting their representation in scientific and technological leadership.
As fulfilling as her work has been thus far, Koofhethile harbours plans to return home and do more with regards to HIV research, women’s development and science development. However, she believes that there is a great number of women involved in science and research in Botswana, but they are not celebrated enough. So, we need to celebrate these wonderful women in science in order to make science careers more attractive to the young girls.
This will increase the Global numbers of women in science. We also need our government to direct funding towards basic science research in Botswana to allow us to do research in our own country as Batswana and solve problems affecting us as a nation,” she asserted. She envisions an Africa that would be the hub of research, science and technology and be able to attract more research funding.
Despite the government of Botswana’s ambition to have one of its own to lead Southern Africa Development Community (SADC) since its establishment in 1980, the Presidency says there is no budget specifically dedicated to the campaign.
The Government has released the name of Permanent Secretary to the President, Elias Mpedi Magosi, as the candidate for the SADC Executive Secretary position. Magosi is expected to face off with Democratic Republic of Congo (DRC) candidate, Faustin Mukela. The position will become vacant in August this year.
However, despite the optimism the Botswana Government has not yet set aside a budget to assist Magosi to win against the seemingly DRC giant. “We all know that the COVID-19 pandemic has negatively affected the country’s ability to effectively fund any new project. This campaign is not an exception. As such, we do not have any budget for the campaign. However, we have so far managed to take advantage of His Excellency the President’s working visits to the neighbouring countries to also carry out the campaigns,” Press Secretary to the President, Batlhalefi Leagajang, explained.
Botswana has housed SADC since the establishment of the then SADCC in 1980, but has never occupied top most leadership positions at the SADC Secretariat. “We therefore, strongly believe that we should also have an opportunity to contribute to the management of our regional body as it continues to drive the important issues of regional integration industrialization and socio-economic development.
This will also profile Botswana as a strong advocate of regional integration,” he responded to this publication’s questionnaire as to why the Government wants to occupy the plum post. SADC is a Member State driven organization. As such, Leagajang said, needs a well-grounded Executive Secretary with a blend of management and leadership acumen; a transformational leader with political awareness and integrity; private and public sector experience; a deep culture of corporate governance; as well as strategic agility and result-oriented consummate diplomat.
“These are the unique attributes of our candidate,” he said. So far President Mokgweetsi Masisi has visited nine out of 16 SADC member states on a working visit and also taking an opportunity to present to them his candidate.
“The countries have appreciated this effort and we remain hopeful. However, it is important to note that this is a democratic and competitive process which must be respected,” he responded when asked about the reception and assurances from various countries to cast a vote for Magosi.
In 2018, when Pelonomi Venson-Moitoi challenged for the Africa Union (AU) Chairperson, the government appointed former President Festus Mogae to be the campaign leader. Does the Government have anyone apart from Masisi to help with the campaign?
“The campaigns for the candidate are strictly led by the Government of Botswana. Since this is a candidate for Botswana, not just the Government, it will be appreciated if all Batswana, including the media, could also shoulder the responsibility to campaign for the candidate in their own spheres of influence,” Leagajang responded.
While there are sceptics on Magosi winning against the DRC man, the Government is confident and believes that with the unique traits that he possess, Magosi stands a chance. He is said to be a strong advocate of justice and fairness as he has played this role in his current role as PSP and in his previous roles as PS and in the private sector. He has helped individuals and companies to find justice and fairness in most of their dealings with Government.
Magosi is also said to be a proponent of corporate governance and which he has relentlessly pursued in most of his career including in Government and other sectors. A strong believer in following laid down procedures and laws. “He carries a variety of skills as an HR expert with experience in different sectors, a strategist and an Organization development specialist.
His experience and exposure spans government, parastatal, private sector and at regional level as well, thus making him a suitable candidate for the regional role. He has worked with governments, businesses, development partners and politicians and is comfortable navigating through all of them,” Leagajang concluded.
The Minister of Land Management, Water and Sanitation Services, Kefentse Mzwinila looked a politician set to shoot the moon as he laid bare his billions of pula development agenda recently in Parliament.
His Ministry’s combined Recurrent and Development Budget Proposals for the 2021/ 2022 Financial Year is pegged at Four Billion, Three Hundred and Sixty – Five Million, two Hundred and Nineteen Thousand, Five Hundred and Sixty Pula (P4, 365, 219, 560). This is a budget 38.3% more than the allocation for the 2020/2021 Financial Year.
Mzwinila preluded his request to parliament with a demonstration that his Ministry has no champagne taste on a beer budget – indicating that his ministry’s expenditure at the end of February 2021P2.111 Billion or 96% of development budget; and P910 million or 90% of the recurrent budget.
Notwithstanding the budget dust, the Minister justified this year’s increase in the Ministry’s total budget. He attributed the escalation to the commencement of major projects under the water sector. These include the implementation of the North South Carrier (NSC) 22.2 covering various sub projects. Mzwinila noted that these are all public value projects which are aimed at improving the lives of Batswana.
Mzwinila’s Ministry has projected that the sum of Nine Hundred and Sixty –Three Million, Nine Hundred and Forty – Seven Thousand, Five Hundred and Sixty Pula (P963, 947, 560) be permitted for the Recurrent Budget and stand part of the 2021 / 2022 Appropriation Bill ( No. 1 of 2021).
“55% of the Recurrent Budget is geared towards the Revenue Support Grant for 12 Land Boards and their subordinate authorities while the sum of P5 Million is allocated to the Real Estate Advisory Council (REAC). The remaining 44% is proposed for the Ministry Departments.”
The sum of Three Billion, Four Hundred and One Million, Two hundred and Seventy –Two Thousand Pula (P3, 401, 272, 000), for the Development Budget was approved and stand part of the same schedule of the appropriation (2021/2022).
When breaking down the Development Budget, Minister Mzwinila noted that Water Supply and Sanitation projects will account for P1.098 Billion to finance the Maun Water and Sanitation project, Molepolole Sanitation projects and the Shakawe Water Treatment Plant Rehabilitation.
With all the implementation bottlenecks troubling several projects in the country, Mzwinila had to satisfy the question of whether his Ministry demonstrated a dire need for the budget with reference to its execution of the budget for the financial year 2020/2021 and its delivery of strategic initiatives and projects?
Mzwinila’s pitch found favour with parliament and his ministry will get an aggregate budget of P3.198 Billion for the 2020/ 2021 Financial Year. Within this allocation, P2.188 Billion is for the Development Budget and P1.010 Billion will cover the Recurrent Budget.
The Minister revealed his strategic interventions for land management, water and sanitation services. Highlighting that efforts by Government to provide serviced residential land to citizens on the waiting list are being hampered by limited resources. He shared that his ministry needs P94 Billion to cover such costs which will directly link to water, sewage, roads, electricity, telecommunications and storm water drainage leading to the allocation of 4 587 plots on un-serviced land.
The minister projected that 22 952 un-serviced residential plots are planned to be allocated in the next financial year. However, there is a trend where allocated land remains fallow and undeveloped which raises misgivings that the requests could have been made on speculative plans.
Mzwinila noted that in the spirit of forging stronger International connections, the Ministry will in June 2021 sign a Memorandum of Understanding on Land matters between Namibia and Botswana with the aim of opening doors to the creation of Dry Ports in the country, facilitate international trade through Walvis Bay Sea Port.
Botswana is already challenged by scarcity of naturally occurring water resources due to the aridity of the country creating persistent water shortages. The type of infrastructure required to improve national water security is a true reflection of intensive investment needed in the water sector The Minister stressed.
“An emerging issue such as the COVID -19 pandemic poses serious challenges as the control of the virus requires reliable water supply. In an effort to mitigate the challenge, the Ministry has undertaken extensive bowsing throughout the country which included the provision of additional capacity for supplementary bowsing to areas with pervasive water shortages, plus an additional forty one (41) un-gazetted settlements.
Operational costs due to bowsing were at an average of P6 Million per month before the COVID-19 pandemic and increased to an unsustainable amount of the order of P13 Million per month, since the beginning of the State of Emergency in April 2020,” the minister shared.
Through the support of a World Bank Loan, the Ministry is implementing several initiatives under the Botswana Emergency Water Security and Efficiency (BEWSE) project. Through BEWSE the Raw Water Pricing and Abstraction Strategy will assess the pricing of water in a manner that enables the provision of water to support new economic development, the strategy is planned to be completed in June 2021.
The Ministry has commenced the development of a long term National Water Security Strategy to improve resilience to climate change impacts. The strategy development entails prioritization of the proposed future mega water transfers such as the Chobe – Zambezi water transfer, the Atlantic Ocean water transfer to Botswana through Namibia and Lesotho – Botswana water transfer.
Following the signing of the tripartite Memorandum of Agreement (MoA) between Botswana, Lesotho and South Africa in November 2017 for the Lesotho –Botswana Water Transfer project, a 24 months contract for a combined prefeasibility and feasibility study for the development of a bankable Lesotho – Botswana Water Transfer project feasibility study was signed and is to be completed in 2022.
One of the Ministry’s famous major water supply projects such as the North South Carrier (NSC) 2.2 has experienced hiccups; having tenders for contract 1 (Masama to Mmamashia Pipeline) and Contract 2 (Mahalapye to Masama Pipeline) cancelled due to budgetary constraints.
The Botswana Climate Change policy draft of 2021 was tabled in Parliament by the Minister of Environment, Natural Resources Conservation and Tourism, Philda Kereng for consideration and adoption.
The policy attempts to indicate the country’s environmentally conscious development agenda as Substantial resources are being dedicated to research and policy efforts to mitigate climate change and support adaptation to the current and future impacts of greenhouse gas emissions.
Kereng indicated that Botswana is not immune to the impacts of climate change and it continues to delay the country’s national development efforts and that the key economic development sectors dependent on the climate system have recorded declines over the years due to the variability of the rainfall and other climatic conditions. Experts elsewhere have pointed out that lack of consideration of population dynamics hampers the development of stronger, more effective solutions to the challenges climate change poses – hopefully this policy if effectively implemented could partly answer this question.
Kereng underscored that sectors such as agriculture, water, bio diversity, health and tourism have suffered the most and the consequences of these have contributed significantly to the decline of livelihoods in Botswana especially in rural areas.
To respond to the changing climate, Botswana has embarked on sectoral reform such as climate smart agriculture, poverty alleviation initiatives, building resilience on the economic productive sectors, diversification of tourism for the improvement of livelihoods and income generation, local economic development and sustainable environment.
The efforts require a coordinated mechanism that will provide an enabling environment for an integrated approach to the formulation and implantation of development plans and socio economic related policies in Botswana that are responsive to the changing climatic conditions.
Minister Kereng explained the draft policy is characterized by an inclusive and integrated approach to social, economic development and governance modalities that would enable the country to achieve a sustainable development pathway. It provides opportunities for improved livelihoods through creation of green jobs, development and transfer of relevant technologies as well as creation and ease of access to both local and international markets. It also commits the government, private sector and non-state actors to adopt adaptation and mitigation measures that would facilitate sustainability and building of resilience of all sectors.
While Members of Parliament were trying to comprehend the policy, this publication got in touch with Green Botswana to solicit their views on the policy draft. Ms. Sela Motshwane, the Founder of the Trust highlighted that “the Climate Change policy was meant to be read in August 2019. It is long overdue, and we all need to see it and understand it in full.
I understand the current budget does not allow for a full implementation- but I could be wrong. More funds could have been allocated since. I think generally, Batswana need to understand fully what this means to our daily lives. I believe the true understanding is by policy drafters and the Ministry of Environment only.”
In the same vein, Green Botswana Trust took to the streets to provide a community solution to climate change on World Health Day (Wednesday). Green Botswana held a “Free Trees for Babies” at Extension 2 Clinic where fruit trees were gifted to parents, expectant mothers, 25 health workers, police officers and the prison officers who had accompanied prisoners to the clinic.
Motshwane said: “The decision to do the “Free Trees for Babies” by gifting fruit trees was to raise awareness to our imminent food security issue as stated by the Deputy Permanent Secretary of the Ministry of Agricultural Development and Food Security, Mr. Thabang Botshoma and encourage the general public to plant a tree so that we can reach our SGD Goal 13 : Climate Action. The trees gifted are to be named after the baby recipient”.
Green Botswana is calling for the urgent action from government and members of the public to create a culture of community accountability and collegiality in moving Botswana towards climate action and sustainability. To achieve the 2030 Paris Agreement Pledge, it will take all citizens and not just the government to reach goals.
Parliament resolved to adopt the Botswana Climate Change Policy, 2021.