Botswana was once ‘at risk of extinction’ from HIV. Now it is a world leader in eliminating the virus in children

Edwin Motse, an HIV-positive Aids activist in Botswana with his daughter Ompi, who is HIV-negative thanks to modern preventive techniques. At the turn of the century HIV had almost doubled mortality rates among children under five. Photograph: Peter Van Agtmael/Polaris/eyevine

At the turn of the century, HIV was so rampant in Botswana that politicians and doctors viewed it as an existential threat. One in eight infants were reported to be infected at birth, while rates of mother to child transmission either through pregnancy, childbirth or breastfeeding ranged from between 20 and 40%, according to UNAIDS. Between 1990 and 2000, mortality among children under five almost doubled due to HIV.

With a population of just 1.7 million people, no cure available and the second-highest HIV prevalence in the world, the country’s then-president, Festus Mogae, declared in 2001: “We are threatened with extinction.”