Botswana’s Shifting Role in HIV Prevention
Botswana, once a leader in the global fight against HIV, faces new challenges in adopting advanced prevention methods. While neighboring countries embrace long-acting pre-exposure prophylaxis (PrEP) technologies like Lenacapavir, Botswana’s hesitant approach has drawn scrutiny.
The Puzzle of Hesitation
Previously recognized for its innovative HIV response, Botswana’s current delay in implementing newer PrEP technologies is notable. This stands in contrast to the rapid adoption seen elsewhere in the region, raising questions about the country’s current HIV governance strategies. The perceived inaction of the Botswana Medicines Regulatory Authority (BOMRA) is a particular point of concern.
A Legacy of Success, A Glimpse of Fragility
Botswana’s achievements in HIV care are significant. The nation has surpassed UNAIDS 95-95-95 targets, earned WHO Gold Tier status for eliminating mother-to-child HIV transmission, and maintained high rates of viral suppression. These clinical successes, however, are juxtaposed with recent vulnerabilities.
In 2025, widespread shortages of antiretrovirals (ARVs) and essential medical supplies exposed systemic weaknesses. This event, which disrupted healthcare services and eroded public trust, harked back to difficulties not experienced since before the widespread availability of antiretroviral treatment. This incident highlights the underlying fragilities within Botswana’s health system, even amidst its celebrated progress.
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