The African Comprehensive HIV/AIDS Partnership (ACHAP) demonstrates how public/private partnerships can make a meaningful and lasting contribution to a major public health challenge, helping to restore hope and transform the morale and prospects of an entire nation.

ACHAP has made a significant contribution to Botswana's response to the HIV and AIDS epidemic and has served as a catalyst for providing urgently needed infrastructure, equipment, human resources, training and program support for the Botswana ARV program. Major achievements of the program:

• Halved the mortality rate in adults, saving over 50,000 lives between 2002 and 2007
• Dramatically reduced mother-to-child transmission and reduced new infections among children by at least 80 percent
• Contributed to significant improvements in blood supply safety
• As of February 2011, more than 163,000 patients were receiving ARV treatment in Botswana, which is approximately 94 percent of the population in need of treatment. This is up from less than 5 percent when the program began and the highest coverage rate in Africa.
• Constructed, by 2009, 35 infectious disease care clinics, providing treatment access in all districts
• Developed sustainable treatment by supporting the recruitment of over 200 positions, on civil service terms, to help staff the treatment program and its rollout to the clinics over the project period. Through successful absorption of these staff positions into the government establishment, and with ongoing training of new staff, patient access to treatment is now available in over 200 clinics countrywide.
• Supported the development of the first National Strategic Framework for HIV and AIDS (2003-2009) and the second National Strategic Framework (2010-2016)
• Increased laboratory capacity so that more than 130,000 patients could be supported in their treatment in the public sector through a decentralized diagnostic and monitoring capacity that increased from an initial 2 referral centers to 14 district and primary hospitals. This enabled the system to cope with up to 20,000 new patients per year.
• Supported the introduction of routine HIV counseling and testing as part of normal medical care
• Provided, in collaboration with Harvard University and the Botswana Ministry of Health, training for more than 7,600 of Botswana's healthcare workers in eight core modules on HIV and AIDS clinical care, largely with in-country faculty. This effort expanded on an earlier effort in which more than 3,200 physicians, nurses and other healthcare professionals received hands-on, clinic-based training from international HIV and AIDS experts through the partnership's preceptorship program between 2002 and 2006. The preceptorship program has now been incorporated into the ongoing national clinical training program managed by the government of Botswana, another example of successful local capacity development.
• ACHAP is currently transitioning its treatment program support to the Government of Botswana a process reflecting the manner in which this program has matured over the past decade.

ACHAP has also made significant contributions in the area of HIV prevention, including the development of a national plan for scaling up prevention, as well as improving condom availability and safe blood transfusions. However, ACHAP has not had the same impact in helping to drive prevention during the first phase of the program as effectively as it did treatment. Interventions need to be rapidly scaled up to slow the spread of HIV infection and meet the ambitious national goal of "zero new infections by 2016."