Photo by Oyemike Princewill on Unsplash (illustrative)
On 20 May 2025, the World Health Organization certified Botswana as the first country in the world to reach 'gold tier' status on the Path to Elimination of mother-to-child transmission of HIV. Botswana is a country with a high HIV burden, which makes the result especially striking.
Key facts
Gold tier means fewer than 250 new HIV infections in children per 100,000 live births each year.
At least 95% of pregnant women attend antenatal care, are tested for HIV and, if positive, receive treatment.
In 2024, 98% of the roughly 220,000 women living with HIV in Botswana were on antiretroviral therapy.
Botswana moved from silver tier in 2021, when it was also the first in the world, to gold tier in about three years.
Why it matters
Without treatment, the risk of a mother passing HIV to her baby can be as high as 45%. Botswana shows that even a country with a high HIV burden can protect almost every newborn through strong primary health care.
Worth noting
Gold tier is a step on the path to full elimination, not elimination itself. Botswana's program has long relied on support from international partners such as PEPFAR, so stable funding matters for keeping the gains.