Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19

Southern African Journal of HIV Medicine

Field Value
Title Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19
Creator Jefferis, Keith Avalos, Ava Phillips, Heston Mmelesi, Mpho Ramaabya, Dinah Nkomo, Bornapate Muthoga, Charles Jarvis, Joseph N. Ratladi, Siphiwe Selato, Robert Stover, John
Subject — Botswana; Spectrum; GOALS; economic modelling; COVID-19; treat all
Description Background: As the relentless coronavirus disease-2019 (COVID-19) pandemic continues to spread across Africa, Botswana could face challenges maintaining the pathway towards control of its HIV epidemic.Objective: Utilising the Spectrum GOALS module (GOALS-2021), the 5-year outcomes from the implementation of the Treat All strategy were analysed and compared with the original 2016 Investment Case (2016-IC) projections. Future impact of adopting the new Joint United Nations Programme on HIV/AIDS (UNAIDS) Global AIDS Strategy (2021–2026) targets and macroeconomic analysis estimating how the financial constraints from the COVID-19 pandemic could impact the available resources for Botswana’s National HIV Response through 2030 were also considered.Method: Programmatic costs, population demographics, prevention and treatment outputs were determined. Previous 2016-IC data were uploaded for comparison, and inputs for the GOALS, AIM, DemProj, Resource Needs and Family Planning modules were derived from published reports, strategic plans, programmatic data and expert opinion. The economic projections were recalibrated with consideration of the impact of the COVID-19 pandemic.Results: Decreases in HIV infections, incidence and mortality rates were achieved. Increases in laboratory costs were offset by estimated decreases in the population of people living with HIV (PLWH). Moving forward, young women and others at high risk must be targeted in HIV prevention efforts, as Botswana transitions from a generalised to a more concentrated epidemic.Conclusion: The Treat All strategy contributed positively to decreases in new HIV infections, mortality and costs. If significant improvements in differentiated service delivery, increases in human resources and HIV prevention can be realised, Botswana could become one of the first countries with a previously high-burdened generalised HIV epidemic to gain epidemic control, despite the demands of the COVID-19 pandemic.
Publisher AOSIS
Date 2021-10-15
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — —
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajhivmed.v22i1.1275
Source Southern African Journal of HIV Medicine; Vol 22, No 1 (2021); 11 pages 2078-6751 1608-9693
Language eng
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Rights Copyright (c) 2021 Ava Avalos