Since 1997, the government has been significantly more proactive in combating the epidemic. Under the governments of Festus Mogae, a programme was introduced in 1999 for the Prevention of Mother-to-Child Transmission (PMTCT). In August 2000, the Gates Foundation, with the Harvard AIDS Initiative and the pharmaceutical companies Merck and Bristol-Myers Squibb, started an HIV/AIDS treatment program, working with the government. The program's target was to treat every citizen of Botswana infected with HIV/AIDS. In addition, anti-retrovirals (ARVs) would be given out to those who were at an advanced stage of the disease. However, Botswana lacked adequate health-care workers and a stable medical infrastructure to implement the program. In 2003, the government introduced the first National Strategic Framework against AIDS. In 2004, with adult HIV prevalence at nearly 40 percent nationwide, the government introduced routine HIV testing for citizens. By 2008, spending on Botswana's response to HIV/AIDS had risen to US$340 million, of which approximately two-thirds was provided by Botswana's central government (a significantly higher proportion than in other sub-Saharan nations).