Recasting Sustainability: A Case for the Reevaluation of a Sustainable Healthcare Model for HIV Programs in Botswana

Today, the global public health community places an emphasis on creating “sustainable” intervention mechanisms that integrate with local governments and existing infrastructure for long term success. Through an in-depth evaluation of Botswana’s public-private healthcare intervention to combat HIV/AIDS, with supporting on-the-ground interviews and extensive evaluation of published data, I argue that key factors deemed essential for long-term sustainable healthcare programs have the potential to isolate and additionally harm certain segments of a population. Given the distinct marginalization of key populations, the concept of sustainability needs to be recast in a manner that achieves health for all segments of a population.