Botswana-Baylor pediatric HIV/AIDS program: The impact 20 years later

When it opened in 2003, the Botswana-Baylor Children’s Clinical Centre of Excellence (Botswana-Baylor Trust) was the first pediatric HIV clinic on the African continent. Two decades later, its impact is clear – more than 39,0000 children and family members have benefited from HIV/AIDS care and treatment, contributing significantly to Botswana’s near elimination of mother-to-child transition of human immunodeficiency virus (HIV).  

The Botswana-Baylor Trust is a public-private partnership between the government of Botswana and the Baylor College of Medicine International Pediatric AIDS Initiative at Texas Children’s Hospital (BIPAI), established with significant support from the Bristol Myers Squibb Foundation. It provides free-of-charge, state-of-the-art pediatric HIV, oncology and blood disorder care, treatment and support to children, adolescents and their families through the Centre of Excellence and decentralized outreach services across the country.

20th anniversary celebration

Leaders from all three organizations marked the 20th anniversary of the Botswana-Baylor Children’s Clinical Centre of Excellence at a ceremony and celebration in Gaborone, Botswana’s capital, on June 26.

“In 2001, His Excellency Dr. Festus Gontebanye Mogae, then president of the Republic of Botswana, famously proclaimed to the United Nations General Assembly that ‘We are on the brink of extinction.’ Bristol Myers Squibb responded by announcing Secure the Future, a $100 million initiative to combat HIV/AIDS in the five highest HIV-burden countries in southern Africa. Through this initiative, the Botswana-Baylor Children’s Clinical Centre of Excellence was created,” said Mike Mizwa, president, Texas Children’s Global, CEO, Baylor College of Medicine Global Health, and board chairman, Botswana-Baylor Trust.

“Over the next couple of years, we tested and treated thousands of mother-baby pairs, children and families, with HIV morbidity and mortality plummeting. As a result of this transformational impact, Secure the Future supported replicating our Botswana-Baylor public-private partnership model in Lesotho, Eswatini, Malawi, Uganda and Tanzania. Today, this Texas Children’s Global Network of Children’s Centres of Excellence is the world’s largest and most robust pediatric HIV care and treatment program in world,” Mizwa said.

Attending the special event along with Mizwa were His Excellency Dr. Mokgwetsi Eric Keabetswe Masisi, president of Botswana; His Honour Mr. Slumber Tsogwane, vice president of Botswana; Dr. Giovanni Caforio, chairman, Bristol Myers Squibb Foundation, and chairman and CEO, Bristol Myers Squibb; Sandra Leung, board member, Bristol Myers Squibb Foundation, and executive vice president, general counsel, Bristol Myers Squibb; and John Damonti, president, Bristol Myers Squibb Foundation. Dr. Paul Klotman, Baylor College of Medicine president and CEO and executive dean, was unable to attend due to travel complications and joined the celebration virtually.

“At Baylor College of Medicine, we are very proud of our global health program and our longstanding relationship with the Government of Botswana. None of this would have been possible without the tremendous leadership and commitment by the various partners, including the Government of Botswana, Bristol Myers Squibb and the BMS foundation,” Klotman said. “Not only do we remain committed, but we are also extremely excited to support and expand our other programs with the Government of Botswana and the University of Botswana.”

“We are proud to partner so closely with the government of Botswana and Baylor to transform care for children in need, first with HIV and later with cancer,” Caforio said. “The Bristol Myers Squibb Foundation’s work to help communities prevail over serious diseases is truly embodied in this partnership, and we are committed to training more healthcare providers, reaching even more children, and continuing to reduce the disparity of health outcomes among children and their families in sub-Saharan Africa.”

Botswana-Baylor background

Botswana-Baylor first opened as an HIV/AIDS clinic in two storerooms at the Princess Marina Hospital in Gaborone before moving into the Centre of Excellence on the hospital campus. Today, the Botswana-Baylor Children’s Clinical Centre of Excellence is one of the world’s largest pediatric HIV/AIDS centers in the world. There were nearly 2,500 HIV-positive clients on anti-retroviral therapy in 2022, with 92.6% of patients with suppressed viral loads. In December 2022, the World Health Organization announced the Republic of Botswana as the first “high burden” country to be certified for achieving key milestones for the elimination of mother-to-child transmission of HIV. High-burden countries are defined as those with more than 2% of pregnant women living with HIV.

After establishing itself as a leader in pediatric HIV care – serving as the model for the BIPAI network across sub-Saharan Africa and beyond – the Botswana-Baylor Centre of Excellence eventually started offering oncology and blood disorder care. The Botswana-Baylor Children’s Centre of Excellence and the government partnered to build the first children’s hematology and cancer center of excellence in Gaborone, again with key initial support from the Bristol Myers Squibb. This met an important need in sub-Saharan Africa, where about 100,000 children a year are diagnosed with cancer in sub-Saharan Africa, and only 20% of those children survive, compared with 80% in the U.S.

Dr. David Poplack, professor of pediatrics at Baylor College of Medicine and former longtime director of the Texas Children’s Cancer and Hematology Center, helped lead the effort to expand cancer and hematology care in Botswana, working in partnership with Bristol Myers Squibb.

The 20th anniversary celebration included welcome remarks by Prof. Mogomotsi Matshaba, executive director of Botswana-Baylor Children’s Clinical Centre of Excellence, a keynote address by the First Lady of the Republic Botswana, Her Excellency Neo Masisi, and performances by the Botswana-Baylor Gospel Choir and young adults served through the Centre.