During the plenary session of the Seventy-eighth World Health Assembly, the Director-General awarded Botswana for achieving gold tier status on the Path to Elimination of mother-to-child transmission of HIV as a public health problem.
Botswana was already the first country in the world to meet the criteria for silver tier status on the path to elimination of HIV, in 2021. Now, Botswana is the first country to achieve gold tier status, by reaching stringent targets in reducing annual case rates of new HIV paediatric infections from <500 per 100 000 live births to <250 per 100 000 live births, and an increase in service coverage from 90% to 95% of antenatal care attendance, HIV testing and treatment of pregnant women living with HIV.
Botswana accomplished this within 3 years thanks to immense efforts by the Ministry of Health, partners and community stakeholders. Botswana has made noteworthy strides since 2021, including revitalizing its primary healthcare system by integrating HIV services across different tiers of healthcare delivery and improving quality of community-based health interventions.
Countries attaining a tier on the Path to Elimination, like Botswana, have >2% maternal prevalence of HIV and must have demonstrated that they deliver robust services for pregnant women and their infants, ensure quality data and laboratory systems, and implement services in a manner consistent with human rights, gender equality and community engagement.
Since 2017, high HIV burden countries that are making progress toward elimination can obtain certification of their progress through the Path to Elimination and its 3 levels of achievement – bronze, silver and gold. In 2023, WHO awarded Namibia on the bronze tier for the Path to Elimination of MTCT of HIV. Namibia is also the first and only country to be awarded on the Path to Elimination of MTCT of hepatitis B virus at the silver tier.
Countries prioritizing the “triple elimination” of mother-to-child transmission (EMTCT) of HIV, syphilis, and hepatitis B virus (HBV) as a public health priority aim to integrate health service delivery to improve the health and well-being of pregnant women and their children.
Criteria for the validation of triple elimination were published by WHO in 2021.