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    US retreat stalls Botswana’s HIV prevention outreach

    A simple, one-time procedure that sharply lowers HIV risk has long been a quiet success story in Botswana — until U.S. funding cuts halted the community outreach behind it.

    By Andrew Green // 04 December 2025

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    GABORONE, Botswana —Thatayaone Rampe has lost count of how many thousands of men he has talked into getting circumcised.

    Rampe, 41, first learned about voluntary medical male circumcision, or VMMC, in the months after an expert panel convened by the World Health Organization recommended the procedure to reduce the risk of HIV transmission in 2007. Their guidance was based on evidence from three independent trials in Africa, each confirming that circumcision could reduce a man’s risk of being infected by a female partner by around 60%.

    Funders, especially the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, began investing in VMMC programs across 14 countries in sub-Saharan Africa, including in Botswana, where Rampe lives.

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    More reading:

    ► HIV prevention services hit hardest by funding cuts, UNAIDS warns

    ► US aid cuts overshadow HIV research advances

    ► In Malawi, the fight to get HIV services back on track post-USAID cuts

    • Democracy, Human Rights & Governance
    • Global Health
    • Humanitarian Aid
    • Trade & Policy
    • Gaborone, Botswana
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    About the author

    • Andrew Green

      Andrew Green@_andrew_green

      Andrew Green, a 2025 Alicia Patterson Fellow, works as a contributing reporter for Devex from Berlin.

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