Botswana has become the first African country – and the first globally with a high HIV burden – to achieve the World Health Organisation’s Gold Tier status for eliminating mother-to-child transmission of HIV, marking a milestone in global public health.
According to the UN Population Fund (UNFPA), the WHO designation, awarded in May 2025, affirmed that Botswana had met rigorous criteria under the UN-led Triple Elimination Initiative that aims to halt vertical transmission of HIV, syphilis and hepatitis B.
“This is a huge accomplishment for a country with one of the most severe HIV epidemics in the world, which in 1999 had an estimated HIV prevalence among adults as high as 30 percent,” the UN agency said on Wednesday.
According to UNAIDS, only 1.2 percent of infants born in Botswana in 2023 contracted HIV, with fewer than 100 total cases recorded.
UNFPA noted that this historic achievement proved that even countries hardest hit by HIV could reach elimination targets through innovation, investment and inclusive health systems.
It attributed the achievement to reforms undertaken by the Botswana authorities over the past two decades.
These include the early adoption of lifelong treatment for pregnant and breastfeeding women (Option B+), universal free antiretroviral therapy for citizens and non-citizens, and extensive community engagement to reduce stigma and strengthen adherence to prevention and treatment.
The government’s digital health infrastructure, including the Open Medical Record System (Open-MRS), and decentralised care delivery via district health management teams, have also helped ensure continuity of care and data-driven progress.
Civil society also played a pivotal role, engaging communities through partner-testing campaigns, male-friendly health platforms and public awareness initiatives.
JN/APA