Botswana leads Africa in eliminating mother-to-child HIV transmission

BOTSWANA—Botswana has made history as the first high HIV-burden country in the world—and the first in Africa—to be awarded the World Health Organization’s (WHO) Gold Tier status for eliminating vertical transmission of HIV as a public health issue.

This remarkable achievement highlights over 20 years of dedicated leadership, innovation, and strong partnerships aimed at tackling one of the world’s most challenging epidemics.

The Gold Tier validation confirms Botswana’s success in meeting and surpassing the key indicators required to eliminate mother-to-child transmission of HIV.

According to the latest UNAIDS data from 2024, Botswana has around 360,000 people living with HIV.

Impressively, 98% of pregnant women living with HIV in the country are receiving treatment.

Thanks to these efforts, the rate of HIV transmission from mother to child has dropped to just 1.2%, well below the 5% target set by the WHO.

 In 2023, fewer than 100 infants were born with HIV in Botswana.

Dr. Chikwe Ihekweazu, Acting Regional Director of the WHO Regional Office for Africa, praised Botswana’s accomplishment, emphasizing that it demonstrates what is possible when political will, strong health systems, and equitable healthcare come together.

Botswana’s Gold Tier status follows a thorough evaluation by WHO’s Regional and Global Validation Committees, which confirmed that the country has not only maintained but strengthened its HIV prevention programs since earning Silver Tier recognition in 2021.

This success aligns with WHO Africa’s Regional Triple Elimination Initiative, which aims to stop the vertical transmission of HIV, syphilis, and hepatitis B through integrated, patient-centered care.

The validation process, led by WHO in partnership with UNICEF and UNAIDS, uses standardized criteria to assess progress.

 While 19 countries worldwide have been certified for eliminating mother-to-child transmission of HIV and/or syphilis, Botswana stands out as the first high-burden country to reach this level, setting a powerful example for others.

Etleva Kadilli, UNICEF Regional Director for Eastern and Southern Africa, called this a major milestone not only for Botswana but for the entire region.

Since 2010, 2.6 million new HIV infections in children have been prevented in Eastern and Southern Africa, marking one of the greatest public health successes in recent decades. Botswana’s progress shows that an AIDS-free generation is achievable.

Botswana’s success is built on pioneering interventions such as the early adoption of Option B+—which offers lifelong HIV treatment to all pregnant and breastfeeding women living with HIV—free antiretroviral therapy for everyone, including non-citizens since 2019, and decentralizing services through local health management teams.

Anne Githuku-Shongwe, UNAIDS Regional Director for East and Southern Africa, described Botswana as a beacon of hope.

She noted that with bold leadership, community involvement, strategic action, and perseverance, ending AIDS in children is within reach—even in countries with high HIV burdens.

Facing reduced donor funding as a middle-income country, Botswana has proactively developed an HIV Sustainability Roadmap.

This plan focuses on increasing domestic funding, fostering public-private partnerships, and exploring innovative financing to safeguard the progress made.

Looking forward, Botswana is committed to achieving Triple Elimination—the integrated elimination of mother-to-child transmission of HIV, syphilis, and hepatitis B.

This includes expanding screening and treatment for hepatitis B and syphilis, integrating these services into antenatal care, and increasing community engagement.

As Eastern and Southern Africa continues to bear more than half of the global HIV burden, Botswana’s achievement proves that ending vertical transmission of HIV is not a distant dream but a goal within reach for the region and the world.

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