Global HIV hits 30yr low, but stubborn risks remain
Mbongeni Mguni | Monday August 24, 2026 15:42
Botswana remains one of the world’s luminaries in the fight against HIV/AIDS. According to a recently released UNAIDS report, Botswana has not only maintained its position amongst the handful of 95-95-95 states, but emerged as the country where children are most covered by the key metrics.
Announced a decade ago as a way of ending the AIDS epidemic by 2030, UNAIDS set the 95-95-95 targets with the aim that by 2025, 95% of all people living with HIV would know their status, 95% of those who were diagnosed would be on antiretroviral therapy (ARVs), and 95% of those who were on ARVs would have viral load suppression.
Botswana achieved the target by 2021, becoming just the second country in the world to do so, after Eswatini. The latest UNAIDS report, in which nations now seek to end AIDS as a public health threat by 2030, indicates that by 2025 just 11 countries had met the 95-95-95 target.
The data shows that over the decades, the world has fought well against the disease, with the numbers of people getting HIV and dying from AIDS-related causes dropping to their lowest in more than 30 years, as at 2025.
Despite the commendable achievement, public health authorities note that grave risks confront the new target of 2030.
“Decades of hard work and global solidarity have reduced the annual numbers of people acquiring HIV and people dying from AIDS-related causes to their lowest levels in more than 30 years,” experts said. “AIDS is not over, however. “The world is not on track to achieve the 2030 goal of ending AIDS as a public health threat. “In 2025 alone there were one million more new HIV infections and 400,000 more AIDS related deaths than if we were on track to reach the global targets.”
Globally, the main challenge is the lower funding for prevention and treatment.
“Efforts to reach the 2030 targets are threatened by converging crises, including declines in external financing, high debt burden in the countries most affected by HIV, a growing number of humanitarian crises and displacements globally emerging epidemics such as Ebola, and a backsliding on human rights and gender equality, which all impact HIV services. “The global health financing architecture is changing, driven by significant reductions in external funding, with several donors reducing their aid commitments for HIV, placing profound pressures on national systems that are already struggling to advance progress to end AIDS as a public health threat and to uphold the right to health.”
In Botswana, one of the major challenges is the stubborn persistence of intergenerational and often transactional relationships. Known colloquially as the “blesser” phenomenon, the term is used to sanitise what is in reality an unhealthy relationship where older men, who represent the second largest age group living with HIV, use their finances to woo, coerce and trap young, financially weaker and often naïve teen girls and young women.
The statistics don’t lie, as shown in the last Botswana AIDS Impact Survey (BAIS0, the country’s most authoritative study on HIV trends. By 2021, it was estimated that 2,239 people were being infected every year in the country, with women aged 15 to 24 years accounting for more than a third or 36%. In terms of prevalence, or the number of people living with HIV, adults aged between 50 and 64 accounted for nearly 27%.
Anecdotal evidence suggests that some older men take advantage of young girls and use them sexually as most of the time these are young and have no power to bargain or refuse.
This week, Christopher Nyanga, Ministry of Health spokesperson, told Mmegi, that while Intergenerational and age-disparate relationships are recognised as one contributing factor among several drivers of HIV incidence, combatting the trend goes beyond what the health sector can achieve on its own.
“The drivers of intergenerational relationships are complex and include social norms, economic vulnerability, education, gender inequality, family and community structures and broader socioeconomic conditions,” he said. “These are not issues that the Ministry of Health can resolve alone. “We therefore, need a whole-of-society response involving families, schools, traditional and community leaders, the education and social protection sectors, youth organisations, civil society, the private sector and men themselves.”
Nyanga explained that the role of government is to ensure that these efforts are coordinated, evidence-informed and focused on the underlying determinants, rather than placing the responsibility solely on young people.
“We need to create an environment in which young people have opportunities, agency and access to appropriate prevention services, while communities actively challenge harmful norms and promote healthy, respectful relationships,” he said.
Even with this broader approach, the Ministry is engaging with the stubborn trend. According to Nyanga, the Ministry is strengthening combination HIV prevention for adolescent girls and young women, including HIV testing, condoms, PrEP, comprehensive sexuality education and youth-friendly services.
“We are also addressing gender norms, sexual and gender-based violence, and improving access to services that enable young people to make informed and safer choices. “At the same time, we are strengthening prevention, testing, treatment and viral suppression among men and older partners,” he said.
The numbers show where incidence remains stubbornly high in the country and underlines the impact of intergenerational relationships. According to the last BAIS V study, HIV prevalence among subjects aged between 16 to 64 years old in Botswana was 20.8%, with females higher at 26.2% compared to males at 15.2%.
Young women and teen girls in the study showed the highest HIV prevalence than their male counterparts at 15 years of age, while HIV prevalence was higher amongst females than males in each age group from ages 20–24 years through 40–44 years. Looking at the same report, however, males’ HIV prevalence starts increasing tremendously from 50–64 years.
While the cultural guardrails could have stifled the growth of the blesser phenomenon years ago, the explosion of social media has opened a Pandora’s box. Not only is exploitative intergenerational sex normalised and even promoted through euphemisms such as “blesser” but young girls are swept up in the desire to keep up appearances, in the process falling prey to the predators hiding in plain sight online.
The challenge of the “blesser” phenomenon is that as long as incidence remains stubborn, the country is betraying younger generations and its own future. The country is spending upwards of P1 billion each year on the HIV/AIDS, at a time when other public health prerogatives such as Non-Communicable Diseases, are rising and when budget finances in general is tightening.
“Our ambition is therefore very clear: reduce new infections, keep people healthy and virally suppressed, and make the HIV response progressively more sustainable,” said Nyanga. “Every infection prevented today represents not only a life protected, but also a future cost avoided for the health system, households and the economy.”