08.P0110 - Impact of Infant Feeding Practices - Mullens and Associates

Title: Infant formula preparation and feeding practices among HIV-positive women in the Botswana PMTCT

program

Time and Money: 6 months protocol approval, 4 months study time; $100,000

Local Co-investigator: MOH Nutrition Unit; Botswana National PMTCT Program

Project Description:

A study was conducted in 2006 to assess infant formula preparation and feeding practices among HIV-

positive mothers. Numerous deviations from recommended practices were observed. In 2008, the

WHO/UNICEF IYCF training will retrain health workers in infant feeding counseling. The impact this training

will have on actual practices in the homes of HIV-positive women, however, is unknown. (Another intended

effect of the IYCF training, to decrease the automatic prescription of formula use and increase informed

choice of infant feeding method, will be measured in other ways.)

Evaluation Question: Has there been any improvement in recommended infant formula preparation

practices since the WHO Infant and Young Child Feeding (IYCF) course was used to retrain health workers

in infant feeding counseling?

Methods: Study participants will be identified after delivery and visited at their homes when their infants are

2-4 months old.

Population of Interest:

This is a repeat of a 2006 study and will use the same protocol. HIV-infected women (n=100) intending to

formula feed their infants will be recruited on the postnatal ward of delivery units in three districts in northern

Botswana. Study participants will be visited at their homes when their infants are 2-4 months old. Data from

questions about infant feeding and observations of actual feeding practices will be collected. Data will be

compared to 2006 data.

Technical support for training of study staff and analysis of data will be provided by CDC-Atlanta.

Information Dissemination Plan:

Data on infant formula preparation and feeding practices will be shared with sites, districts, and the national

PMTCT program in order to determine if the IYCF training has had the desired effect and assist in planning

for additional infant feeding quality improvement activities.

Budget justification for Year 1 Budget:

Salaries: $70,000

Supplies: $10,000,

Travel: $10,000

Equipment: $10,000

Total:$100,000

08.P0111 PHE - Infant Morbidity and Mortality

Title: Risk factors for adverse pregnancy outcomes among HIV-infected and HIV-uninfected women in

Botswana

Time and Money: 2 years are required to collect and analyze the data. The Year 1 budget for the project is

$216,000

Local Co-investigator: Local co-investigators will include Dr. William Jimbo, CDC, Dr. Anthony Ogwu

(Botswana-Harvard School of Public Health Partnership [BHP]), Dr. Joseph Makhema (BHP), Dr. Petr Svab

(Princess Marina Hospital), Dr. Tracy Creek (CDC), Dr. Roger Shapiro (BHP), Dr. Shahin Lockman (BHP)

and Jennifer Chen (Harvard Medical School and BHP.)

Project Description: This project will document the rates and etiologies of stillbirth and early neonatal

mortality, and the rates of premature delivery among HIV-infected and HIV-uninfected women in Botswana.

All births occurring at Princess Marina Hospital (PMH) and Scottish Livingstone Hospital (SLH) during a two

year period will be reviewed by chart abstraction. Risk factors for these three adverse pregnancy outcomes

will be explored, including HIV status, CD4 count, ARV use, medications, medical conditions, and

demographics. Mothers with stillbirths and early neonatal deaths will be consented for "verbal autopsies" to

determine the cause of these events; for HIV PCR testing of the stillbirth or infant (if mother HIV-infected);

and for maternal HIV-1 RNA and CD4 cell count testing (if mother is HIV-infected).

Hypotheses:

--Rates of stillbirth, premature delivery, and early neonatal mortality, are increased among HIV-infected

women.

-- Rates of stillbirth, premature delivery, and early neonatal mortality, are increased among HIV-infected

women with advanced disease.

-- The cause of stillbirths, and possibly early neonatal deaths, differs between HIV-infected and HIV-

uninfected women. Early stillbirths may be related to HIV infection in utero. ART may modify the risk of

stillbirths from HIV-infection.

Primary Objectives:

--To determine rates of stillbirth, premature delivery, and early neonatal mortality by maternal HIV status.

--Among HIV-infected women, to determine rates of stillbirth, premature delivery, and early neonatal

mortality by CD4 cell count and by receipt of different ART regimens in pregnancy.

--To determine the causes of stillbirth and early neonatal mortality through verbal autopsies and laboratory

testing, and to determine whether maternal antenatal ART modify the risk for these events.

Secondary Objectives:

--To ascertain the number/proportion of women with known HIV status by the time of delivery (and the

timing of HIV testing) among women who deliver at PMH and SLH.

--To ascertain the total number of HIV-infected women who have CD4 counts measured during pregnancy

(and the timing of CD4 testing).

-- To ascertain the total number of HIV-infected women who have CD4 counts measured during pregnancy

and begin ART ante partum and/or intra partum.

--To determine the total number of HIV-infected women who received CTX during pregnancy.

--To compare infant birth weight by HIV status.

Programmatic Importance/Anticipated Outcomes:

HIV-infection has been associated with adverse pregnancy outcomes, including higher risk of stillbirth.

Stillbirth rates as high as 13% have been reported among HIV-infected women in Africa who were followed

from conception. It remains unknown whether the cause of excess stillbirths is related to HIV infection of the

fetus, or whether maternal ARV use affects the risk of stillbirths among HIV-infected women. Three-drug

ART is recommended during pregnancy for women in Botswana with CD4 cell count greater than 200 and

may be offered to women with higher CD4 cell counts in the future. It is therefore critical to understand the

background rate and cause of stillbirths in Botswana, and whether ART influences the stillbirth rate. These

data may also guide the decision for when to start ART during pregnancy.

The anticipated outcomes of this study are: 1) To create a large database that provides information about

stillbirth, prematurity, and early neonatal mortality rates in Molepolole and Gaborone, Botswana, and to

provide information about risk factors for these events.

2) To provide detailed information about the causes of stillbirth and early neonatal mortality to the Botswana

government and the scientific community, and determine whether differences exist by HIV status and ART

receipt. 3) To determine whether stillbirths in Botswana are related to fetal HIV infection, and if so, whether

the timing of infection (and other risk factors) affect the likelihood of stillbirth. 4) To understand whether

ART, and the duration of ART exposure, might modify the risk for stillbirth related to HIV-infection.

Methods:

This study will be carried out at PMH and SLH. There are approximately 5,000 births per year at PMH, and

approximately 2,500 births per year at SLH. Therefore, data will be collected from up to 15,000 births over 2

years. If it is feasible to perform the study at the Gaborone City Council maternities, several thousand

additional deliveries may also be available from Gaborone.

On a daily basis for up to 24 months, study researchers will assess the obstetrical records and other

available medical records of all women admitted to the maternity ward of the participating sites. Attempts

will also be made to identify and document stillbirths in cases where women are seen at either antenatal

clinics or on the female medical ward.

Study researchers will work with maternity nurses to anonymously extract data from the obstetrical records

of women who deliver at these sites. The information likely to be available from the obstetric and medical

records includes maternal age, the clinic where obstetrical care was provided, HIV status (if known), CD4

cell count if HIV-infected (and if performed), drugs taken during pregnancy, gestational age at delivery,

pregnancy outcome (live birth versus stillbirth), and birth weight. Information will also be obtained regarding

Activity Narrative: early neonatal mortality, recording all infant deaths that occur in the hospital within 72 hours of delivery. The

information will be entered anonymously into a database.

When stillbirths or early neonatal deaths (greater than72 hrs) are identified, study staff will be informed by

maternity nurses at PMH and SLH. Mothers will be contacted by study staff, and asked for consent for

further evaluation of the cause of stillbirth/death. Verbal autopsies will be performed to provide details of the

pregnancy, maternal medical history, and information about the fetus or infant (including feeding history).

Stillborn fetuses / deceased infants will be examined by the study physician to rule out gross congenital or

other abnormality. When women are HIV-infected, consent for HIV PCR testing of stillbirths and infants, and

maternal HIV-1 RNA and CD4 cell count testing, will be obtained. HIV PCR testing of stillbirths will be

obtained by cardiac puncture.

Budget justification for Year 1 Budget:

Salaries; $206,000

Supplies: $ 1,000

Travel: $ 5,000

Laboratory: $ 4,000

Total: $216,000

08.P0517 Harvard - infant male circumcision

note: April 08 Reprogramming- +$40,000 due to additional administrative costs while awaiting clearance.

This activity supports the Botswana-Harvard Partnership (BHP) to conduct a pilot test of an expanded infant

male circumcision program in 4 hospitals. The evaluation will identify medical, cultural,

programmatic/economic and ethical issues to consider in scaling up infant male circumcision for HIV

prevention in Botswana. Two letters of support for this activity from the Ministry of Health are in the

appendix of this Operational Plan.

Many studies have shown a protective effect of male circumcision on acquisition of HIV. Circumcision of

infants is easier and safer than that of adolescent or adult men. Previous work has shown that women and

men in Botswana find male circumcision to be an acceptable HIV prevention strategy.

In this activity, Harvard will ascertain 1) parental acceptance/uptake in the face of actual, expanded service

delivery options; 2) feasibility and safety of modern male circumcision techniques in existing service delivery

sites; and 3) satisfaction with results by parents of infants. Secondary objectives include 1) determining

factors associated with the uptake of infant circumcision, 2) evaluate safety and outcomes of Mogen vs.

Plastibell techniques in the Botswana setting, and 3) evaluate the cost of the intervention. The population to

be studied will be mothers (and their partners and male infants) at least 21 years of age who deliver in one

of four district hospitals: Scottish Livingstone Hospital in Molepolole; Athlone Hospital in Lobatse; Deborah

Retief Memorial Hospital in Mochudi; and Princess Marina Hospital in Gaborone.

In the proposed study protocol, an experienced urologist will train 2 physicians to conduct circumcisions for

the study. Four nurses will support the study, one in each hospital. Harvard will also train additional

physicians in the techniques as requested by the MOH. Harvard will administer a questionnaire to collect

socio-demographic data and assess knowledge and attitudes about male circumcision from consenting

postpartum mothers of infant boys. Second, these new mothers/parents will be offered circumcision for

their sons, who will be randomized to circumcision using one of two standard techniques (Mogen Clamp vs.

Plastibell) at 1-4 weeks of age. The investigators will monitor complications (e.g. bleeding, infection) and

follow-up infants and parents at 4 weeks and 6 months to ascertain surgical outcomes and parental

satisfaction with results. Investigators plan to accrue approximately 600 mothers in the questionnaire

portion and 300 infants in the circumcision portion over 12-18 months from among the approximately 9,000

births/year in the four hospitals.

The study team will also develop or adapt family education materials that could be used in future expansion

of infant male circumcision in Botswana. These materials may include hand-outs for parents and family

members of the infants and visual aids to assist with parent education in the clinic setting. Throughout the

pilot and after, Harvard will share progress, achievements, and challenges with the MOH and other key

stakeholders.

Local co-investigators include Dr. J. Makhema, Botswana-Harvard Partnership; Dr. P. Kebaabetswe, CDC;

and Dr. C. Lesetedi, Ministry of Health. Dr. R. Plank of Harvard University will be the primary international

co-investigator and based in Botswana. Approximately $186,000 of the budget is for staff costs in

Botswana, about $5,000 for supplies, $8,000 for participant compensation, $5,000 for travel, and $10,000

for miscellaneous supplies and communication.

08.C0911

The purpose of the national counseling and testing workshop is to bring together implementers and

stakeholders on counseling and testing to:

1. Share information on national strategy, policy and technical issues and current coverage of counseling

and testing services

2. Share experiences on implementation, monitoring and evaluation of CT services

3. Identify strategies for future direction: overcoming challenges and filling gaps. Mullans and Associates will

provide faciltitation services for the workshop, in consultation with the counseling and testing technical

working group. An estimated 150 participants drawn from implementing partners, key stakeholders like the

UNAIDS, WHO, ACHAP and the networks of various HIV and AIDS organisations in Botswana will attend.

The counseling and testing technical working group will closely with the Communications working group to

ensure appropriate invlovement of the media. A deliverable from the workshop will be a report with

recommendations on how to efficiently and effectively strengthen and scale up counseling and testing

services in the country. This workshop is planned to preceed the COP planning exercise so as to draw from

the recommendations that will be made. Funding will cover conference venue, transportation and

accommodation, as well as general conference faciltitation like production of materials and the report.

08.T1102

Associated Funds Administrators

Associated Fund Administrators Botswana (Pty) Ltd (AFA) is an administrator of two medical aid

schemes/insurance organizations namely, Botswana Public Officers' Medical Aid Scheme (BPOMAS) and

Pula Medical Aid Fund (PULA). Through its managed care program, AFA facilitates; the provision of

antiretroviral therapy (ART) to insured patients and Government of Botswana funded patients, as well as

provision of continuous medical education and KITSO training to private practitioners (doctors, pharmacist

etc).

Subsequent to AFA being awarded a tender, in May 2005, to pilot the rolling out of ART services to private

sector through the GOB outsourcing program, to date AFA continues to manage and coordinate the

provision of ART services to GOB funded patients by the private sector (medical doctors, pharmacists and

laboratory services). This is a form of a Public-Private Partnership (PPP).

The AFA managed care program had, as at end of May 2007, about 12 600 patients (6, 800 insured

patients and 5, 800 GOB funded patients) on ART, therefore, it is the largest HIV/AIDS managed care

program in the private sector and nationally, it is the second largest after the GOB MASA program.

In view of the close association between AFA and the national ART program (MASA) and the former's

commitment to ensuring alignment between the public and the private sector with regard to HIV/AIDS

treatment, there is a need to ensure synergy in HIV/AIDS treatment and management training.

As a consequence, the proposed project activities necessarily relate to continually providing continuous

medical education (CME) and KITSO training to private practitioners, the printing and distribution of client

information leaflets for the promotion of information, education and communications (IEC) activities for

members and prospective members of administered schemes. In essence, the project aims to build on and

strengthen activities that would be completed for FY07.

The main objective of the project is to increase access to quality antiretroviral therapy and related services

in the private sector in Botswana, which is aligned to national and international clinical guidelines.

To date, and since we started this project with BOTUSA, we have facilitated the provision of KITSO Training

to 95 different private and public sector practitioners, done eight continuous medical education sessions (in

Francistown and Gaborone) which were attended by a total of 321 private and public sector practitioners. In

addition, more than 2,000 patients (excluding public-private partnership project patients) have been

indirectly reached and increased the number of medical practices providing ART services to 156.

The challenges, as previously reported, continue to be availability of funds, scarcity of IEC specialists to

assist in developing program specific IEC materials, limited capacity of the KITSO faculty to provide KITSO

Training as and when requested.

Going forward, we have decided to develop the IEC materials in-house with oversight from the a member of

the KITSO faculty, establish honorarium for private practitioners willing to accredit and provide KITSO

training to private sector practitioners, and continue to invite resource persons from abroad to provide

Continuous Medical Education, in collaboration with, amongst others, International Training & Education

Centre (I-TECH -University of Washington) and Aid for AIDS consultants from University of Cape Town..

In FY08 at least four continuous medical education sessions for private sector practitioners are planned for

the southern and northern parts of Botswana, two Government of Botswana (Ministry of Health) accredited

HIV/AIDS treatment training (KITSO) to ensure that treatment and/or antiretroviral services offered in the

private sector meet national and international standards. This activity will provide CME and KITSO Training

to about 210 private practitioners.

To strengthen and supplement Government information, education and communication activities (IEC), 15

000 program specific IEC materials / leaflets would be produced to provide knowledge and information to

insured and non-insured persons in order to increase the number of clients accessing the managed care

program and therefore accessing antiretroviral therapy. This would be done at the same time as promoting

HIV preventative strategies such as abstinence, be faithful and condoms (ABC). By distributing the IEC

materials, nationally, to the various employer groups, this activity is expected to increase current new

patients' enrollment rate.

In conclusion, the funding will also support the payment to the resource persons who will be providing the

continuous medical education and the KITSO Training, travel costs to the different training venues, venue

and other related session costs and production and distribution of IEC materials.

08-X1410: IDM - Sustainable Management Development Program

The Sustainable Management Development Program (SMDP), established in 2003 at the Botswana

Institute of Development Management (IDM) with the assistance of CDC/BOTUSA, is based on the CDC

Management of International Public Health (MIPH) Course. The objective of this training is to build the

managerial and leadership capacity of public health program managers working in HIV/AIDS in the public,

non-governmental (NGO), community-based (CBO) and faith-based (FBOs) sectors.

The curriculum is in modular form allowing for shorter training in specific management areas. The major

component of the course is the Total Quality Management (TQM) module, designed to develop problem

solving and analytical skills for improving routine processes and service delivery in public health programs.

Other modules include leadership, communications, team building and strategic resource development.

The training is currently undergoing the accreditation process with the Botswana Training Authority (BOTA),

with two major components of the course, TQM and Effective Communications, in the final stages of

accreditation.

To date, the MIPH course has been adapted to Botswana and a local SMDP program established, ten

trainers have been trained in MIPH in Atlanta, 100 public health managers have been trained in SMDP in

Botswana, an external evaluation was conducted (2005) and the first SMDP Alumni Conference was held

(2007).

2007 achievements:

Trained 120 public health managers in the Botswana SMDP; held first annual Botswana SMDP Alumni

Conference (94 in attendance); two modules in the final stages of accreditation with the local training

authority; developing a mentor program which will train 20 SMDP graduates to be SMDP focal points in their

workplaces; update on the new TQM module scheduled for November

2008 plans:

Train 120 public health managers in SMDP (4 months); train 40 public health managers in TQM (1 week)

from MOH, Laboratory Services, Pharmacy Services and the TB program; train 40 managers from NGO,

CBO and FBO sectors in Leadership, Networking and Strategic Resource Development (1 week); hold

annual two-day conference for 150 Botswana SMDP alumni; train 40 mentors to support and supervise the

applied TQM projects; train one IDM staff member in MIPH course at CDC, Atlanta; train two IDM staff in

advanced public health management courses; course accreditation will continue.

08-X1417: School of Public Health Curriculum Development

Botswana is currently in the process of establishing a medical school at the University of Botswana (UB),

with the first class able to do their entire medical education in country beginning this year. A local internship

program has just begun, residencies in pediatrics and internal medicine are being established and a new

teaching hospital is planned. Aside from the public health component, the curriculum has been developed.

The public health courses, when developed, will be integrated into the medical school curriculum, as well as

the larger Faculty of Health Sciences, with the longer-term vision of establishing a school of public health in

future.

2008 Plans

The activity will support a partner, to provide technical assistance to UB and the new medical school to

develop its public health component. This assistance is likely to focus on faculty recruitment and growth,

curriculum development and the development of distance learning and telemedicine capacity.

08-X1422

The Botswana Network on Ethics, Law and HIV/AIDS (BONELA), a non-governmental organization, is

secretariat to the Ethics, Law and Human Rights (ELRH) sub-committee of the National AIDS Council

(NAC) and is responsible for coordinating the implementation of the sector plan. Many policy and legal

gaps related to HIV/AIDS in Botswana were documented in a 2005 legislative review, particularly in the area

of ethics and human rights, gender and stigma. Among the most important of these are related to

protection from discrimination in employment, women's sexual and reproductive rights and the rights of

marginalized groups, included people with disabilities.Since 2005, BONELA has received USG funding to

employ a policy advisor to implement activities outlined in the ELHR strategic plan. These activities focus on

building consensus among policy makers on legislative and policy reform; developing institutional capacity

for compliance to ethics, law and human rights standards at sector level; and raising public awareness of

ethics, law and human rights issues related to HIV and AIDS. Training workshops address existing gaps in

the knowledge and awareness of human rights issues in Botswana by targeting policy makers, interest

groups, the private sector, community leaders, development organizations, PLWA support groups, District

AIDS Coordinators and the general public. Increasing awareness of prevalent human rights and legislative

issues related to HIV/AIDS is expected to assist in legislative and policy reform and create a supportive

environment for the implementation of reformed laws. 2007 Achievements:180 people (PLWAs,

government workers, policy makers, civil society, private sector) trained to strengthen political and popular

support for HIV/AIDS policies and legislative reform and build capacity to participate in policy development;

conducted national media campaign to create awareness on the need for an HIV employment law; project

to address HIV stigma in schools /is planned to start before the end of the year. 2008 Plans: Conduct

training workshops in 9 districts (100 participants) to address existing gaps in the knowledge and

awareness of legislative and human rights issues in Botswana by targeting policy makers, interest groups,

the private sector, community leaders, development organizations, PLWA support groups, District AIDS

Coordinators and the general public; conduct an awareness raising media campaign using leaflets,

advertorials, radio talk shows to disseminate the results of a situational analysis on vulnerable groups

(women, children, MSM) to be conducted with Global Funds (Round 7); hire a training officer to support the

above activities

08-X1427

Project Name:

Champions for an AIDS-Free Generation

Lead Person:

His Excellency, Mr. Festus G. Mogae, Former President of the Republic of Botswana

Budget: $66,155

Project Summary:

Former President of Botswana, Festus G. Mogae, recognizing the devastating impact that the epidemic

continues to have in Africa; and recognizing that prevention and control of HIV infection is not just a

technical issue, but is embedded in complex political, social, economic, and trade-related contexts, has

considered how to engage renewed efforts and actions that are owned, driven and led by the most affected

countries. The former President calls for the convocation of a regional group of respected statespersons or

‘Champions' to be supported by multilaterals and global partnerships. The group would aim to mobilize

leadership and to catalyze the action needed to inform and invigorate HIV prevention approaches in

Southern Africa.

1. The Champions and their Mission

President Festus G. Mogae will lead the Champions. He and the founding members will provide guidance

on the final composition of this group which will include representatives from the private sector, public sector

and religious leaders - ensuring a strong representation from women and from civil society. The following

Champions have been identified:

• Archbishop and Nobel Laureate, Desmond Tutu

• Former Mozambican President, Joaquim Chissano

• Former Zambian President Kenneth Kaunda

• Former Tanzanian President Benjamin Mkapa

• South African Justice Edwin Cameron

• Ethiopian Supermodel, Liya Kebede

• Chairperson, Kenya National AIDS Commission, Dr. Miriam Were

The Mission of the Champions

President Mogae proposes that this group of distinguished African Champions will serve to mobilize

leadership in the region, inform global leaders and policy makers, and to catalyze the local action needed to

renew and revitalize HIV responses. The mission of the Champions would be to (i) help create an

authorizing environment for a reinvigorated response to HIV, (ii) catalyze debate and dialogue among

political leaders, (iii) mobilize media and public support in the region and (iv) foster mutual accountability

among Governments and Development Partners for resources, and strong, effective policies and action on

HIV prevention and AIDS treatment and care.

President Mogae further proposes that this group of distinguished African Champions will be established to

meet the need for an independent actor with the capacity to be both conscience and champion to mobilize

leadership on HIV in Africa. The Group will recognize the role of other regional initiatives and bodies such

as AIDS Watch Africa and the West African Leaders' Initiative on HIV and will seek to coordinate with and

complement their activities.

President Mogae envisages that the Champions' overall mission is to help improve the quality of the

region's response to AIDS and ensure its implementation by holding leaders accountable for their promises

and performance. The group will achieve this primarily by using their convening power to focus attention on

and analyze country performances to help catalyze the action needed to renew and revitalize HIV

responses. Their mission will have an emphasis on improved and innovative approaches to prevention,

within the framework of the continuum of AIDS treatment, care and support. However the Champions might

also choose to address a broad range of barriers to implementation, including operational and legal issues.

President Mogae envisions that the counterparts and key interlocutors of the Champions will be Heads of

State, relevant sector Ministers, Speakers of Parliament, leaders of civil society and communities affected

by HIV, representative of key government agencies responsible for HIV and representatives of the private

sector and religious organizations of the countries they visit. Recognizing the important regional dimensions

of the HIV epidemic, the Champions will act at country level, dealing with country-specific issues, but also

work with and inform regional institutions and initiatives. The Group may also engage with the international

community including representatives of governments, multilateral agencies, global initiatives, private

foundations and the pharmaceutical industry.

The Champions' major focus will be on Southern Africa on account of the greatest HIV burden in this sub-

region - hence the proposed composition of its membership. Priority will be given to countries of highest

prevalence: Botswana, Lesotho, Namibia, South Africa, Swaziland, Mozambique, Tanzania, Zambia and

Zimbabwe, in 2008 and 2009.

2. The Secretariat

President Mogae has held discussions with the following international agencies and institutions supporting

AIDS programs in Africa, which have committed to providing the Champions with the technical support and

resources they will need: UNAIDS, World Bank, Global Fund, US Government-PEPFAR Program, and

WHO. These partners will act in close consultation and coordination with the Gates Foundation and other

active stakeholders. Their commitment to President Mogae includes the establishment of a small technical

Secretariat to assist and support the group as detailed below.

a. Skills and Role

Activity Narrative:

The Champions will be supported and assisted by a small Secretariat to provide the following support and

resources directly relevant to country visits:

a. Logistical support for country visits;

b. Structural links with the technical support agencies and partners, who at the request of countries will

assist them to:

1. Coordinate and manage country and regional level analytical studies - including background syntheses

and innovative empirical studies as required;

2. Coordinate and manage country "think tanks" - including preparing and disseminating meeting reports;

3. Monitor progress in different countries

c. Preparation of documents and reports on country visits;

d. Technical advice and assistance to the Champions upon request;

e. Liaising with regional structures and other stakeholders at the request of the Champions Group;

f. Coordination with development partners at global and country levels;

3. Inaugral Meeting

This mission is urgent. President Mogae has called a meeting on September 11-12 in Gaborone to

inaugurate the Champions, formalize membership and agree on the formal mission of the group. Support

from BOTUSA will go to hire an Agency to help with the logistics of the meeting, including travel and

accommodation for the Champions and their body guards or personal assistants, the conference venue, a

reception for 30 people, and support to the newly formed Secretariat.