The Government of Botswana (GoB), in its 'VISION 2016' made a commitment to achieve the goal of 'Zero New Infections by 2016'. It is clear that this goal can only be achieved through the design and implementation of robust, comprehensive and sustained HIV/AIDS prevention programmes that address clearly identified interventions and gaps to support the national prevention efforts.

The National Plan for scaling up HIV/AIDS prevention was launched by the Government of Botswana with the endorsement and support of other partners. This achievement of consensus on priority interventions that will guide a renewed focus on HIV/AIDS prevention marks a significant milestone in terms of mobilizing relevant players in the fight against HIV/AIDS in Botswana. Part of the groundwork for the operationalization of the prevention plan y took place in 2008 with financial and technical support from ACHAP.

This included the initiation of the development of the strategy addressing multiple concurrent sexual partnerships and the development of a programme for introduction of safe male circumcision as an added HIV/AIDS prevention intervention, both of which are currently implemented. These developments mark a major milestone in Botswana’s efforts to scale up HIV/AIDS prevention which began with the national prevention conference of 2005, as the recommendations of this conference are now being brought to fruition.

ACHAP has continued to support interventions that respond to the needs of country as part of the national HIV/AIDS prevention response. Some of the programmes supported are:...

ACHAP funded consultation meetings leading to the routine HIV/AIDS testing policy. HIV/AIDS/ counselling and testing (HCT) services are an important component of a comprehensive HIV/AIDS prevention response. They are the entry point to both prevention and treatment. In Botswana where access to treatment services is well established, HIV/AIDS counselling and testing provides an opportunity for people to access the required post test services that include treatment. Therefore HCT services are significantly and aggressively promoted. With the introduction of both voluntary and routine HIV/AIDS counselling and testing, (VCT) there has been a tremendous increase in the numbers of people seeking these services as well as those enrolling for treatment.

Advanced HIV/AIDS Care – The Masa Program In January 2002, the Government of Botswana took the bold step of launching Africa's first national anti-retroviral (ARV) Program – “Masa”. Masa, a Setswana word meaning "new dawn," heralds the rising of a dawn over Botswana's struggle against the HIV/AIDS epidemic and promises Batswana the opportunity to live longer and healthier lives by giving people living with HIV/AIDS more time to nurture their families and to help build a better future for Botswana.

2008 was the second year of support for TB interventions and assistance to the Botswana National TB Programme. The assistance was provided in recognition of the severe TB epidemic closely associated with, and fuelled by the HIV/AIDS epidemic. While there is evidence of a reduction in TB incidence, rates are still extremely high, with close to 500 cases per 100 000 population, and TB continues to be a major cause of morbidity and mortality amongst HIV positive persons.

In line with Botswana national goal of eliminating new HIV infection by 2016, ACHAP is in the process of developing innovative evidence based interventions focused on empowering young women 15-29 years adopt safe and healthy sexual practices. The Epidemiology reveals that young women in Botswana are hyper vulnerable to HIV. While prevalence declines have been recorded among young women aged 15 -24, (18.2% in 2004 to 10.7% in 2008) after two decades prevention interventions, and nine years of a successful public treatment programme, the epidemic remains severe, and incidence levels are high.

ACHAP's support of the treatment programme during Phase I of programme implementation yielded significant gains in terms of national scale-up, coverage and reduction of mortality due to HIV/AIDS. Other partners including PEPFAR and the Clinton Foundation are providing additional support to the Government in the roll out of the ARV treatment programme. With support from these partners and ACHAP's continued support, the ART programme has steadily advanced. Given the changing financial atmosphere, there is a need for balanced resource input considering the need to scale up HIV prevention interventions to a level that will contribute to a significant reduction in HIV prevalence.