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...

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Autores principales:	Keith Jefferis, Ava Avalos, Heston Phillips, Mpho Mmelesi, Dinah Ramaabya, Bornapate Nkomo, Charles Muthoga, Joseph N. Jarvis, Siphiwe Ratladi, Robert Selato, John Stover
Formato:	article
Lenguaje:	EN
Publicado:	AOSIS 2021
Materias:	botswana spectrum goals economic modelling covid-19 treat all Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/6d65c8eb644048febc7085b793d49f0e
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spelling	oai:doaj.org-article:6d65c8eb644048febc7085b793d49f0e2021-11-24T07:47:22ZFive years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-191608-96932078-675110.4102/sajhivmed.v22i1.1275https://doaj.org/article/6d65c8eb644048febc7085b793d49f0e2021-10-01T00:00:00Zhttps://sajhivmed.org.za/index.php/hivmed/article/view/1275https://doaj.org/toc/1608-9693https://doaj.org/toc/2078-6751Background: 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.Keith JefferisAva AvalosHeston PhillipsMpho MmelesiDinah RamaabyaBornapate NkomoCharles MuthogaJoseph N. JarvisSiphiwe RatladiRobert SelatoJohn StoverAOSISarticlebotswanaspectrumgoalseconomic modellingcovid-19treat allPublic aspects of medicineRA1-1270ENSouthern African Journal of HIV Medicine, Vol 22, Iss 1, Pp e1-e11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	botswana spectrum goals economic modelling covid-19 treat all Public aspects of medicine RA1-1270
spellingShingle	botswana spectrum goals economic modelling covid-19 treat all Public aspects of medicine RA1-1270 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
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.
format	article
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
title	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_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_sort	five years after treat all implementation: botswana’s hiv response and future directions in the era of covid-19
publisher	AOSIS
publishDate	2021
url	https://doaj.org/article/6d65c8eb644048febc7085b793d49f0e
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Five years after Treat All implementation: Botswana’s HIV response and future directions in the era of COVID-19

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