Yet in Rwanda, where just 20 years ago a genocide claimed approximately 1 million lives, the government has transformed HIV care for the poor by redefining the standards for successful treatment. More than three decades into the epidemic, many national and international agencies are still counting the basics—how many people get infected, how many people receive medication, how many patients die. Success in Rwanda, meanwhile, is measured not in the number remaining alive, but rather in how many are actually able to take their medications as directed and suppress the virus in their bodies to a level where it is essentially non-existent. In Rwanda, success is achieved when people living with HIV can earn a living, support their family, raise their children, and care for their community no differently than their peers.

As a physician working for Partners in Health in Rwanda, I have witnessed the impact of this relentless approach to HIV care and treatment, and the stabilizing and uplifting impact it has had on the lives of Rwandans. Patients who would have previously been hospitalized with severe and end-stage complications of HIV are now coming for regular, preventive care. Families and communities previously devastated by the dual impact of insecurity and HIV are now thriving hubs for HIV prevention and treatment. I’ve come to realize that this tiny East African country may have large lessons to share with the global HIV movement.

Rwanda is not without its challenges. Though roughly the size of New Hampshire, it is home to more than 200,000 people living with HIV, including 27,000 children. In the capital city of Kigali, nearly one in 12 women between the ages of 15 and 49 are infected with the virus. The average life expectancy, though rising, remains 55 years (compared with 79 years in the U.S.).

Still, in a country where the average income is less than $2 a day, more than 120,000 patients are now being treated for HIV, a tenfold increase since 2004. Put another way, 91 percent of patients in Rwanda requiring HIV medications have access to life-saving treatment, compared with 54 percent worldwide.

Perhaps even more encouraging is that 98 percent of women receive HIV testing during their prenatal visits. Rwanda is one of the first sub-Saharan countries to virtually eliminate the transmission of HIV from mothers to newborn babies. As a result, the number of new HIV cases has been cut by half in the last decade, and Rwanda has made a big step toward fulfilling the dream of “an AIDS-free generation.”

How has Rwanda, one of the 20 poorest countries in the world, managed to become a model for HIV care?

While many countries continue to approach the HIV epidemic in isolation, Rwanda has managed to integrate its response to HIV within its broader platform for social and economic development. Having spent the past three years working in rural Rwanda, it’s astonishing to see how investments in health care infrastructure have manifested in some of the country’s hardest-to-reach areas. More than 400 new health facilities dot the rural landscape, effectively decentralizing health care from major cities to villages. To ensure care is accessible, the government offers community-based health insurance that costs barely $5 per year, which has resulted in health care coverage for more than 90 percent of the population.