Funded by the United States President’s Emergency Plan for AIDS Relief (PEPFAR), the Sustainable Financing Initiative for HIV/AIDS (SFI) aims to increase sustainability of the HIV response by promoting shared financial responsibility with host country governments. Since 2014, the U.S. Agency for International Development (USAID) has implemented SFI in 16 countries and two regional programs, with a budget of nearly $48 million.
Botswana has made significant progress in its response to the HIV epidemic in recent years despite the high HIV prevalence in the country. In 2019 there were an estimated 360,183 people living with HIV (PLHIV) in Botswana, accounting for 14.8 percent of the population. That year, 6,405 people were newly infected with HIV and 4,791 died from an AIDS-related illness.1 The Government of Botswana (GOB) is committed to reducing the effects of HIV/AIDS by increasingly financing its HIV response, up to 74 percent in 2017. While it seeks to provide universal health coverage (UHC) for all, the health system suffers from inefficient use of resources, overburdened public healthcare facilities, and inadequate human resources—all obstacles to controlling the HIV epidemic.
In collaboration with the GOB and other stakeholders, SFI improved the capacity of the Ministry of Health and Wellness to establish and manage public-private contracts for health services. It also built local capacity by strengthening government workers’ public financial management skills and advocating for inclusive policies and benefits for PLHIV in the Universal Health Services Package. These efforts represent important milestones in Botswana’s HIV response.
