Country Spotlight: Lesotho

By EGPAF | June 6, 2014

A mother comforts her son outside their home in Lesotho. Of the 360,000 people living with HIV in Lesotho, nearly 38,000 are children younger than 15.

Jon Hrusa/EGPAF

Lesotho, a country nestled within South Africa, has a land area of only 30,355 square km, and a population of just fewer than 2 million people. But the country does rank second in the world in one very critical measure:  HIV/AIDS prevalence rate.

As of 2012, more than 23 percent of the population in Lesotho was living with HIV. Of these approximate 360,000 people, nearly 38,000 are children younger than 15. AIDS is also the number one cause of death in Lesotho, accounting for 15,000 people in 2012 alone.  This means that 41 AIDS-related deaths occur in Lesotho every day. The burden placed by the epidemic, and other compounding factors, on the country’s health system is immense.

Yet, even in the face of these dire figures, there is cause for celebration and hope. With support from the U.S. Agency for International Development (USAID), the Elizabeth Glaser Pediatric AIDS Foundation began collaborating with the Lesotho Ministry of Health (MOH) in 2004, and together we have made substantial and undeniable progress in the fight against HIV/AIDS.

In the past ten years, EGPAF-supported programs have provided prevention of mother-to-child transmission (PMTCT) of HIV services to more than 167,000 women and started more than 90,000 individuals on antiretroviral therapy, 6,550 of whom are children.  EGPAF now supports more than 140 sites in six districts across the country, and is currently expanding the scope and capacity of its treatment and prevention programs to offer truly comprehensive services to those who need it most.

EGPAF is a national leader in technical HIV strategy and policy, having heavily participated in the development and revision of more than five national guidelines. EGPAF also supports the launch of new and revised guidelines, as well as training programs to ensure that all health care workers are knowledgeable about any changes and have the capacity and confidence to carry out new policies.

The severity of the HIV/AIDS epidemic in Lesotho presents substantial challenges to treatment and prevention that require innovative and multi-faceted solutions. This is why EGPAF is supporting and pursuing a wide range of initiatives in-country that address the entire spectrum of the epidemic’s impact.

This means taking an integrative, comprehensive approach to treatment, such as incorporating child nutrition programs with existing health services to better combat malnutrition among the country’s HIV positive children and help identify additional children living with HIV for initiation on ART.

And we are finding ways to use and implement technology in novel ways.  For example, an EGPAF-supported initiative is leveraging 3G printing technology to reduce test turn-around times to ensure HIV-positive infants are started on treatment as soon as possible. This project is helping to expand mHealth to distribute results from the national laboratory to hard to reach health facilities.

Treating and preventing HIV also means tackling those diseases that often accompany it, such as cervical cancer.  Women living with HIV in Lesotho are four times more likely to develop cervical cancer, which is the leading cause of cancer death among women in the country.  This is why in 2013 EGPAF helped launch the country's first-ever organized cervical cancer screening and prevention facility at the Senkatana Center of Excellence.  The center has already screened more than 2,300 women since opening.  EGPAF has also held cervical cancer treatment and prevention training for nurses and health workers, who can now take and implement this knowledge at the local level.

We have made significant progress in Lesotho and we will continue our work in this remarkable country until the end of AIDS.