Botswana has been getting a lot of calls lately from across the African continent, prodding the nation — once “at risk of extinction” from HIV — to tell the world how they did the impossible: squash childhood HIV rates.

The number of children living with HIV has declined sharply everywhere, but nowhere more so than in Botswana, which has managed to slash its childhood infection rate by more than 98 percent since the 1990s.

At its peak, in what was one of the world’s worst outbreaks of HIV, one in eight infants were infected at birth. Mortality in young kids nearly doubled over a decade, with 3,000 children dying of AIDS each year. And 25,000 children — one in every classroom of 25 — had long-term symptoms of the virus, which without treatment, destroys the body’s immune system, turning even common infections deadly.

Now, new infections in kids are so exceedingly rare — at under 100 per year — that every infant diagnosed with HIV now prompts a comprehensive audit by the country’s public health officials.

It is a remarkable turnaround. While Botswana’s HIV rate is still the fourth-highest in the world — affecting up to a third of adults in some regions — the number of babies born with HIV today is virtually zero.

It took time to pay off, but Botswana has managed to build the most robust HIV prevention infrastructure in sub-Saharan Africa, particularly for pregnant women and children. Life-saving antiretroviral therapies — which can transform HIV into a manageable and largely untransmittable chronic condition — have been widely available for free in the country since 2002. The nation’s government launched a program to prevent mother-to-child transmissions in 1999,

© Vox