Jefferis Keith, Avalos Ava, Phillips Heston, Mmelesi Mpho, Ramaabya Dinah, Nkomo Bornapate, Muthoga Charles, Jarvis Joseph N, Ratladi Siphiwe, Selato Robert, Stover John
E-consult Botswana, Gaborone, Botswana.
Careena Centre for Health, Gaborone, Botswana.
South Afr J HIV Med. 2021 Oct 15;22(1):1275. doi: 10.4102/sajhivmed.v22i1.1275. eCollection 2021.
As the relentless coronavirus disease-2019 (COVID-19) pandemic continues to spread across Africa, Botswana could face challenges maintaining the pathway towards control of its HIV epidemic.
Utilising the Spectrum GOALS module (GOALS-2021), the 5-year outcomes from the implementation of the Treat All strategy were analysed and compared with the original 2016 Investment Case (2016-IC) projections. Future impact of adopting the new Joint United Nations Programme on HIV/AIDS (UNAIDS) Global AIDS Strategy (2021-2026) targets and macroeconomic analysis estimating how the financial constraints from the COVID-19 pandemic could impact the available resources for Botswana's National HIV Response through 2030 were also considered.
Programmatic costs, population demographics, prevention and treatment outputs were determined. Previous 2016-IC data were uploaded for comparison, and inputs for the GOALS, AIM, DemProj, Resource Needs and Family Planning modules were derived from published reports, strategic plans, programmatic data and expert opinion. The economic projections were recalibrated with consideration of the impact of the COVID-19 pandemic.
Decreases in HIV infections, incidence and mortality rates were achieved. Increases in laboratory costs were offset by estimated decreases in the population of people living with HIV (PLWH). Moving forward, young women and others at high risk must be targeted in HIV prevention efforts, as Botswana transitions from a generalised to a more concentrated epidemic.
The Treat All strategy contributed positively to decreases in new HIV infections, mortality and costs. If significant improvements in differentiated service delivery, increases in human resources and HIV prevention can be realised, Botswana could become one of the first countries with a previously high-burdened generalised HIV epidemic to gain epidemic control, despite the demands of the COVID-19 pandemic.
随着2019冠状病毒病（COVID-19）疫情在非洲持续蔓延，博茨瓦纳在维持其艾滋病疫情控制道路上可能面临挑战。
利用Spectrum GOALS模块（GOALS-2021），分析了“全面治疗”战略实施5年的成果，并与2016年最初的投资案例（2016-IC）预测进行了比较。还考虑了采用联合国艾滋病规划署（UNAIDS）新的全球艾滋病战略（2021-2026年）目标的未来影响，以及宏观经济分析，估计COVID-19疫情带来的财政限制如何影响博茨瓦纳国家艾滋病应对行动到2030年可获得的资源。
确定了项目成本、人口统计学、预防和治疗产出。上传了2016-IC以前的数据进行比较，GOALS、AIM、DemProj、资源需求和计划生育模块的输入数据来自已发表的报告、战略计划、项目数据和专家意见。考虑到COVID-19疫情的影响，对经济预测进行了重新校准。
实现了艾滋病毒感染、发病率和死亡率的下降。实验室成本的增加被估计的艾滋病毒感染者（PLWH）人数的减少所抵消。展望未来，随着博茨瓦纳从广泛流行向更集中流行的转变，艾滋病毒预防工作必须针对年轻女性和其他高危人群。
“全面治疗”战略对新的艾滋病毒感染、死亡率和成本的降低起到了积极作用。如果能够在差异化服务提供方面取得显著改善、增加人力资源并加强艾滋病毒预防，尽管有COVID-19疫情的需求，博茨瓦纳仍有可能成为首批在以前艾滋病负担较重的广泛流行国家中实现疫情控制的国家之一。
