Assesses fiscal policy challenges arising from HIV/AIDS response in order to develop tools to better understand the linksbetween the HIV/AIDS program and the fiscal costs of HIV/AIDS, as well as inform the planning of the national responseand fiscalplanning in general.Botswana has one of the highest levels of HIV prevalence in the world(24.8 percent among those aged 15–49 or 320,000 people). Key health indicators have deteriorated catastrophically—life expectancy at birth declined from 66 years in 1990 to 50 years in 2002, recovering only partly to 54 years by 2008. The scale of the epidemic brings extraordinary policy challengesfor planning, managing, and financing the response, with estimates and projections suggesting fiscal costs will rise from Pula(P) 3 billion (2010) to P 5.5 billion by 2030, peaking at 3.5 percent of GDP around 2016, and slowly declining to 3.3 percent of GDP by 2030.