In his ‘Mother-to-Child Transmission of HIV in Botswana: an Ethical Perspective on Mandatory Testing’, Peter Clark controversially defends compulsory testing – and even compulsory treatment– of pregnant mothers in an African country with one of the world’s highest HIV prevalence rates. He argues, on consequentialist grounds, that the urgency of the epidemic in Botswana requires a radical change in HIV policy from the traditional autonomy-centered model of voluntary testing and counseling (VCT) to a public health-centered model of non-voluntary HIV testing. Even the latest model of routine HIV testing embraced by the World Health Organization (WHO) – where patients in clinics are told they will be tested unless they refuse – fails to go far enough for Clark, apparently because he fears that some patients may ‘opt-out’ of the program. Clark’s proposal is also more radical than the current initiative in Lesotho, which tests individuals for HIV door-to-door but only after gaining consent. According to Clark, the radical policy of mandatory testing of pregnant women in Botswana may have its costs, but it is a lesser evil than the death and social destruction caused by HIV/AIDS.