Botswana and the United States have marked more than three decades of cooperation in public health, celebrating a partnership that has played a major role in transforming the country’s response to HIV, tuberculosis and other health challenges. The Ministry of Health joined the United States government to recognise the longstanding collaboration between Botswana and the U.S. Centers for Disease Control and Prevention, commonly known as the U.S. CDC. Since the partnership began in 1995, it has supported the development of stronger healthcare systems, laboratory services, disease surveillance and health workforce capacity. It has also contributed to research and evidence-based programmes that have influenced HIV policies beyond Botswana’s borders. The anniversary provides an opportunity to reflect on the partnership’s achievements while looking ahead to new public health priorities that will require continued cooperation, scientific innovation and investment.
The partnership between Botswana and the U.S. CDC emerged at a critical period for the country’s public health system, particularly as HIV and tuberculosis placed increasing pressure on communities and healthcare services. Over the years, cooperation between the two countries has helped Botswana strengthen its ability to prevent, diagnose and treat major infectious diseases. The collaboration has extended beyond individual health programmes to include laboratories, surveillance systems, healthcare training and institutional capacity. These areas are essential because an effective public health response depends on more than access to medicines alone. Strong data systems, skilled healthcare workers, reliable laboratories and effective disease monitoring all contribute to a health system that can respond quickly to changing needs.
One of the most significant areas of cooperation has been Botswana’s response to HIV. The partnership supported programmes that expanded access to HIV testing, treatment and care while helping strengthen the systems required to deliver these services at scale. The Masa programme became an important part of Botswana’s HIV response, helping to expand access to antiretroviral treatment and improve the management of people living with HIV. The country also strengthened the integration of tuberculosis and HIV services, recognising the close relationship between the two diseases and the need for coordinated care. These efforts contributed to major improvements in Botswana’s HIV response and helped establish programmes that have attracted international attention.
Speaking at the anniversary event, Vice President Ndaba Nkosinathi Gaolathe highlighted several landmark achievements associated with the partnership. Among them were the Masa programme, integrated TB and HIV services and Botswana’s achievement of WHO Gold Tier Status. These accomplishments demonstrate the impact that sustained cooperation can have when governments, health institutions, scientists and development partners work towards clearly defined public health goals. Botswana also became the first country to exceed the UNAIDS 95-95-95 targets ahead of schedule, representing a major achievement in the global HIV response. Reaching these targets means that a very high proportion of people living with HIV know their status, people who know their status have access to treatment and those receiving treatment have achieved viral suppression.
Botswana’s progress towards the UNAIDS 95-95-95 targets reflects years of investment in testing, treatment, patient support, monitoring and health system strengthening. Achieving such results requires coordinated action across communities, healthcare facilities, laboratories and government institutions. It also requires people living with HIV to have access to services that are affordable, accessible and effective over the long term. The country’s achievement therefore represents more than a statistical milestone because it demonstrates the ability of a national health system to translate policy into measurable outcomes. The experience has also provided lessons that can inform HIV programmes in other countries facing similar public health challenges.
The partnership has also contributed significantly to Botswana’s laboratory capacity. Strong laboratory systems are essential for identifying diseases, confirming diagnoses, monitoring treatment and detecting emerging health threats. Through collaboration and technical support, Botswana has strengthened laboratory capabilities that support both routine healthcare and public health surveillance. Better laboratory systems also improve the quality and speed of health information available to policymakers and healthcare professionals. This capacity became particularly important as health systems around the world faced increasingly complex infectious disease threats and the need for rapid, evidence-based decision-making.
Disease surveillance has been another important area of cooperation between Botswana and the U.S. CDC. Effective surveillance allows health authorities to identify disease patterns, monitor outbreaks and make informed decisions about where resources are needed most. Strong surveillance systems can also help governments detect emerging threats before they develop into larger public health emergencies. Botswana’s investment in this area has strengthened the country’s ability to collect and analyse health information across different programmes. Continued improvement in surveillance will remain important as the country responds to both established diseases and new health risks.
The development of Botswana’s healthcare workforce has also formed an important part of the partnership. Public health programmes require trained professionals who can provide quality services, analyse data, conduct research and manage complex health interventions. Capacity building has helped strengthen skills across different areas of the health system while supporting greater local expertise. Building a strong healthcare workforce also reduces reliance on external technical support over time and allows national institutions to take greater ownership of health programmes. This approach can contribute to a more sustainable health system that is better prepared to respond to future challenges.
Research has provided another major foundation for the Botswana-U.S. CDC partnership. Scientific research conducted through the collaboration has generated evidence that has contributed to the development and improvement of HIV policies at both national and international levels. Research allows health authorities to understand which interventions work, identify gaps in services and adapt programmes according to evidence. Botswana’s experience has therefore contributed not only to its own health policies but also to broader discussions about HIV prevention, treatment and care. The anniversary celebration highlighted these scientific innovations and demonstrated the value of maintaining strong links between research, policy and healthcare delivery.
The more than 30-year partnership also demonstrates the importance of sustained international cooperation in addressing complex public health challenges. Health threats can evolve over time, requiring governments and institutions to adapt their strategies while maintaining effective systems that already work. Botswana and the United States have built a relationship that has supported this type of long-term adaptation through technical cooperation, scientific research, capacity building and programme development. The achievements recognised at the anniversary event show what can be accomplished when partnerships are maintained over decades rather than limited to short-term interventions. They also provide a foundation for addressing emerging challenges that may affect Botswana and the wider region.
Looking ahead, the Ministry of Health and its partners will need to build on these achievements while responding to changing public health needs. HIV and tuberculosis will remain important priorities, but health systems must also prepare for emerging infectious diseases, changing population needs and other pressures on healthcare delivery. Continued investment in laboratories, surveillance, research and healthcare workers will help Botswana maintain the progress it has made. Scientific innovation will also remain important as new technologies and approaches create opportunities to improve disease prevention, diagnosis and treatment. The anniversary therefore served not only as a celebration of past achievements but also as a reaffirmation of the need for continued cooperation.
The more than 30 years of partnership between Botswana and the U.S. CDC demonstrate how sustained cooperation can produce lasting improvements in public health. From strengthening HIV and tuberculosis services to improving laboratories, surveillance and healthcare workforce capacity, the collaboration has supported important changes across Botswana’s health system. Landmark achievements such as the Masa programme, integrated TB and HIV services, WHO Gold Tier Status and Botswana’s success in exceeding the UNAIDS 95-95-95 targets show the scale of progress achieved. The partnership has also generated research and scientific knowledge that has influenced HIV policies globally, giving Botswana an important role in the international health community. As both countries look towards the future, continued collaboration can help protect these gains, strengthen health systems and ensure Botswana remains prepared to address the next generation of public health challenges.
