Botswana has become the first country in the world to reach Gold Tier status for eliminating mother-to-child transmission of HIV. The milestone, confirmed in the WHO Botswana Biennial Report 2024–2025, marks a historic leap in public health and reflects years of focused political commitment and integrated primary care.
A first-of-its-kind global health achievement
The Gold Tier designation is the highest recognition under the World Health Organization’s validation process for eliminating HIV transmission from mother to child. Botswana achieved this by weaving HIV prevention and treatment into routine maternal and child health services, ensuring that pregnant women receive antiretroviral therapy and that exposed infants are tested and treated early. The country’s success did not happen overnight. It required sustained investment in health infrastructure, training for health workers, and a nationwide effort to reach women in even the most remote areas.
Strengthening the broader health system
Beyond the HIV milestone, Botswana has made progress in other critical areas. The report highlights advances in immunization coverage, disease control programs, and health security. The country completed a Joint External Evaluation of its preparedness for health emergencies and developed a fully costed National Action Plan for Health Security. These steps are part of a larger push toward Universal Health Coverage and the introduction of National Health Insurance, which aims to make care more accessible and affordable for all citizens.
Local impact and what comes next
For people in Botswana, the Gold Tier status means fewer babies born with HIV and healthier families. It also signals that the health system can handle complex, long-term challenges. Yet the report notes that emerging issues remain, including the rise of non-communicable diseases such as diabetes and heart conditions, the need for continued investment in health facilities and equipment, and the recovery of routine services that were disrupted during the pandemic. WHO Botswana thanked national and international partners for their collaboration and said it looks forward to deepening those partnerships to build a more resilient health sector.
This achievement places Botswana at the forefront of global HIV elimination efforts. It shows that with sustained political will and a health system built on primary care, a country can turn a devastating epidemic into a manageable condition and protect the next generation from infection.
