The partnership between the U.S. Centers for Disease Control and Prevention (CDC) and the Government of Botswana (GOB) began in 1995 with the goal of strengthening tuberculosis (TB) prevention and control through public health research. In 2000, the partnership grew to include HIV prevention, care, treatment, and strategic information for program development to maximize the quality, coverage, and impact of Botswana’s national response to the HIV epidemic. In 2013, CDC, in partnership with the Botswana Ministry of Health and Wellness (MOHW) and the Harvard School of Public Health launched a four-year study called the Botswana Combination Prevention Project (also known as Ya Tsie), which was a randomized trial designed to examine whether a combination of HIV prevention measures could reduce HIV incidence, compared to the standard of care. Concluded in late 2018, the results have led the way in innovative testing, linkage to care, and retention strategies. There were several lessons learned regarding health management information system challenges, poor documentation of viral load testing, and other key operational and research questions have been rapidly translated into the overall CDC and the U.S. President’s Emergency Plan for AIDS Response (PEPFAR) Botswana programs for maximum impact.

The CDC Office supports and partners with the GOB through PEPFAR, to provide high quality services linkages to and retention in HIV care and treatment for people living with HIV (PLHIV). The Voluntary Medical Male Circumcision (VMMC) program helps adolescent boys and men to remain HIV-free. Our implementing partners (IPs) enhance quality services through training, mentoring and supportive supervision, routine and comprehensive site monitoring visits, remediation plans, and follow-up action.

CDC also supports the MOHW to enhance cervical cancer detection and prevention among women living

with HIV. Through its IP, CDC supports 71 sites in 17 high HIV burden districts of the 27 districts in Botswana.

The support is across the clinical cascade and includes client-centered health services. In addition, our team

maximizes strategies such as PrEP and Prevention of Mother-to-Child Transmission (PMTCT), key

components of combination HIV Prevention efforts that will contribute to reduction in HIV infections. CDC

Botswana supports efforts to prevent vulnerable young girls and their partners from acquiring HIV through

building capacity of government facilities to offer youth-friendly services as well as establish safe spaces

for young girls, the implementation of the comprehensive Determined, Resilient, Empowered, AIDS-free,

Mentored and Safe (DREAMS) program towards building networks in the communities, and to have a

productive life free of HIV. CDC Botswana supports quality laboratory testing for the diagnosis and care of

PLHIV and with TB. Our strategic information support is critical to the development, implementation, and

dissemination of population-based surveys, as well as the quality of national health information systems

and PEPFAR monitoring and evaluation systems. Our science program contributes to knowledge related to

HIV, TB, and cervical cancer. Another key focus area is to assist the GOB in establishing the Botswana Public

Health Institute, and a Field Epidemiology Training Program, while leveraging current CDC Botswana staff

to support the prevention, detection, and control of public health diseases. The COVID pandemic has

demonstrated the critical need to have systems in place where trained epidemiologists can be on the front

lines of the public health response.

Botswana.pdf