Since 2017 as part of the Breaking Down Barriers program, Botswana has received funding from the Global Fund to remove human rights-related barriers to HIV services. Breaking Down Barriers (BDB) provides funding for “comprehensive” programs to remove rights-related barriers, meaning the scaling up of a set of internationally recognized human rights programs. Countries are also supported to create enabling environments to advance comprehensive rights-based responses to HIV, TB and malaria. In late 2021, Botswana was also reported to be the first high-burden country to have met UNAIDS criteria for being in the “silver tier” on the path to elimination of mother-to-child transmission of HIV. In 2022, it was announced that Botswana was the third country in the world to reach and exceed the 95-95-95 goal for HIV testing, treatment and viral suppression.

The HIV testing and treatment cascade estimate was 95-98-98. Considering where Botswana started, with one of the highest national HIV burdens in history, the achievements have been truly remarkable. But concerns about stigma, discrimination and other human rights-related barriers remain especially for key populations, particularly sex workers, LGBTQI persons (that is lesbian, gay, bisexual, transgender, queer or questioning and intersex persons), and adolescent girls and other young people. The prevalence of HIV among sex workers, for example, is estimated to be 42%.