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The prevalence of HIV in West Africa is lower than elsewhere in Africa butGabon has one of the highest rates of HIV in that region. Gabon has a smallpopulation and a high per capita gross domestic product making it an idealplace to carry out a programme of early treatment for HIV. The effectiveness,availability and affordability of triple combination therapy make it possibleto contemplate ending AIDS deaths and HIV transmission in the short term andHIV prevalence in the long term. Here we consider what would have happened inGabon without the development of potent anti-retroviral therapy (ART), theimpact that the current roll-out of ART has had on HIV, and what might bepossible if early treatment with ART becomes available to all. We fit a dynamictransmission model to trends in the adult prevalence of HIV and infer trends inincidence, mortality and the impact of ART. The availability of ART has reducedthe prevalence of HIV among adults not on ART from 4.2% to 2.9%, annualincidence from 0.43% to 0.27%, and the proportion of adults dying from AIDSillnesses each year from 0.36% to 0.13% saving the lives of 2.3 thousand peoplein 2013 alone. The provision of ART has been highly cost effective saving thecountry at least $18 million up to 2013.

Ending AIDS in Gabon: How long will it take? How much will it cost?