The President’s Emergency Plan for AIDS Relief (PEPFAR) initiative is the largest commitment ever by a nation toward an international health initiative for a single disease. The Office of the U.S. Global AIDS Coordinator (S/GAC) is responsible for implementing PEPFAR. To control and ultimately end the HIV/AIDS epidemic, collective gains must be expanded and sustained. Led by S/GAC’s strategic vision, PEPFAR 3.0 – Controlling the Epidemic: Delivering on the Promise of an AIDS-free Generation, PEPFAR is collecting and using data in the most granular manner (disaggregated by sex, age, and at the site level) to do the right things, in the right places, and right now within the highest HIV-burdened populations and geographic locations.

The PEPFAR program in Botswana combines the talents of staff members and operational partners from the Department of State (DOS), the Centers for Disease Control and Prevention (CDC), the Health Resources and Services Administration (HRSA), the Department of Defense (DOD), the U.S. Agency for International Development (USAID), and the Peace Corps to implement an integrated HIV/AIDS program. These entities have come together to create a program that supports activities in Botswana and allows for a rapid, unprecedented expansion of programs and services. This expansion takes into account expected inputs from the Global Fund, other donors and the Government of Botswana (GoB) itself. While the GoB and donors, including the United States, strive to work toward epidemic control, the scope, magnitude and urgent focus on results of the PEPFAR program create challenges and pressures due to differing perspectives, interests and agendas of the diverse implementing partners.

As the program in Botswana has expanded, the need for more effective integration of USG plans with those of other donors and the host government has become increasingly important. Managing these external relationships is a high priority for the Embassy’s Front Office, the PEPFAR Coordinator, and the Agency Leads.