Global AIDS Technical Assistance Triangulation Project and Case Study in Botswana
Investigator: George W. Rutherford, MD
Sponsor: World Health Organization (WHO)
In 2002, the Government of Botswana rolled out a national programme for the treatment of AIDS with antiretroviral therapy (ART). In 2005, the impact of this ART scale-up programme was assessed by the National AIDS Committee of the Botswana Ministry of Health (MOH), together with the World Health Organization (WHO), the Joint United Nations Programme on HIV/AIDS (UNAIDS), and the University of California, San Francisco’s (UCSF) Institute for Global Health, using country-enhanced monitoring and valuation methodology tailored specifically to the situation in Botswana. The following case report summarizes the methodological process that was used in Botswana in 2005 to determine the impact of the ART and prevention of mother-to-child transmission (PMTCT) scale-up programmes. Using triangulation, the researchers were able to develop a model to assess the impact of ART and PMTCT in Botswana. Preliminary results indicated that, during the three years since its inception, the ART programme in Botswana has reduced mortality in adults aged 25–54 years. We also found that early initiation of district ART programmes and the overall rate of ART uptake in the district were associated with reduced mortality.