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