Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19
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 impleme...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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AOSIS
2021-10-01
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| Series: | Southern African Journal of HIV Medicine |
| Subjects: | |
| Online Access: | https://sajhivmed.org.za/index.php/hivmed/article/view/1275 |
| _version_ | 1818140642344173568 |
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| author | Keith Jefferis Ava Avalos Heston Phillips Mpho Mmelesi Dinah Ramaabya Bornapate Nkomo Charles Muthoga Joseph N. Jarvis Siphiwe Ratladi Robert Selato John Stover |
| author_facet | Keith Jefferis Ava Avalos Heston Phillips Mpho Mmelesi Dinah Ramaabya Bornapate Nkomo Charles Muthoga Joseph N. Jarvis Siphiwe Ratladi Robert Selato John Stover |
| author_sort | Keith Jefferis |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-11T10:47:14Z |
| format | Article |
| id | doaj.art-6d65c8eb644048febc7085b793d49f0e |
| institution | Directory Open Access Journal |
| issn | 1608-9693 2078-6751 |
| language | English |
| last_indexed | 2024-12-11T10:47:14Z |
| publishDate | 2021-10-01 |
| publisher | AOSIS |
| record_format | Article |
| series | Southern African Journal of HIV Medicine |
| spelling | doaj.art-6d65c8eb644048febc7085b793d49f0e2022-12-22T01:10:26ZengAOSISSouthern African Journal of HIV Medicine1608-96932078-67512021-10-01221e1e1110.4102/sajhivmed.v22i1.1275773Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19Keith Jefferis0Ava Avalos1Heston Phillips2Mpho Mmelesi3Dinah Ramaabya4Bornapate Nkomo5Charles Muthoga6Joseph N. Jarvis7Siphiwe Ratladi8Robert Selato9John Stover10E-consult Botswana, GaboroneCareena Centre for Health, GaboroneUNAIDS, LusakaUNAIDS, GaboroneBotswana Ministry of Health and Wellness, GaboroneBotswana Ministry of Health and Wellness, GaboroneBotswana Harvard AIDS Institute Partnership, GaboroneBotswana Harvard AIDS Institute Partnership, Gaborone, Botswana; and, Department of Clinical Research, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, LondonNational AIDS and Public Health Agency, GaboroneNational AIDS and Public Health Agency, GaboroneAvenir Health, Glastonbury, United States of AmericaBackground: 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.https://sajhivmed.org.za/index.php/hivmed/article/view/1275botswanaspectrumgoalseconomic modellingcovid-19treat all |
| spellingShingle | Keith Jefferis Ava Avalos Heston Phillips Mpho Mmelesi Dinah Ramaabya Bornapate Nkomo Charles Muthoga Joseph N. Jarvis Siphiwe Ratladi Robert Selato John Stover 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 botswana spectrum goals economic modelling covid-19 treat all |
| title | Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19 |
| title_full | Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19 |
| title_fullStr | Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19 |
| title_full_unstemmed | Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19 |
| title_short | Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19 |
| title_sort | five years after treat all implementation botswana s hiv response and future directions in the era of covid 19 |
| topic | botswana spectrum goals economic modelling covid-19 treat all |
| url | https://sajhivmed.org.za/index.php/hivmed/article/view/1275 |
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