“We strongly believe that with this project we have the chance to make history in the fight against AIDS,” said Michelle Gavin, U.S. Ambassador to Botswana, at the November 8th press conference in Gaborone announcing the launch of the Botswana Combination Prevention Project.
The project is called Ya Tsie in Setswana, the language of Botswana. The name comes from a proverb that roughly translates as “Teamwork bears more fruit than individual effort.” Ya Tsie is a collaboration with the Botswana-Harvard Partnership, Botswana’s Ministry of Health, and the U.S. Centers for Disease Control and Prevention.
In Botswana, where 24% of the adult population has HIV, about 12,000 new infections occur annually. Botswana has reached a tipping point where the annual increase in adults receiving antiretroviral treatment is greater than the annual number of adults becoming infected with HIV. The more people who are on treatment, the less chance there is for the virus to spread within a community.
The goal of Ya Tsie is to determine whether combining and strengthening HIV prevention methods can prevent the spread of HIV within a community more effectively than using standard methods alone. If the hypothesis is correct, the interventions should have a mutually reinforcing effect that is greater than the sum of the parts.
Ya Tsie will run for four years in 30 villages and involves over a 100,000 people. Participants will receive household visits and services that may include HIV testing and counseling, antiretroviral treatment, male circumcision, and treatment for prevention of mother-to-child transmission of HIV. Some prevention services will be expanded to reach HIV-infected individuals with high viral loads. The goal is to significantly reduce the number of new HIV infections within a community.
Max Essex, Chair of HAI and the Principal Investigator of the study, has spent much of the last year on the enormous task of planning Ya Tsie. “The project includes two innovations—targeting HIV carriers that are the most likely to transmit based on viral load and evaluating transmission networks based on viral mutation patterns,” said Essex.
In Africa and around the world, we urgently need better ways to stop the spread of HIV/AIDS. Ambassador Gavin stressed the importance of Ya Tsie in addressing that need. “If this combination prevention strategy is shown to be effective and affordable, Botswana will be a global leader in providing scientific evidence needed to turn the tide on this epidemic.”