Lesotho
Lesotho has the third highest adult HIV prevalence in the world at 23.2%. There are an estimated 62 new HIV infections and about 50 deaths due to AIDS each day.1 There were an estimated 270,273 people living with HIV in Lesotho as of end 2007. Of these 11,801 were children and 258,472 adults. Women are more likely to be HIV positive as estimated 153,581 are living with HIV compared to 116,692 men
There has been no significant change in the national adult HIV prevalence since 2005. There appears to be a slightly downward trend in the HIV prevalence among young people aged 15-24 with 8.9% in 2007 compared to 11% in 2005.1 The adjusted HIV prevalence among women aged 15-24 was 14.9% compared to 5.9% among men in the same age group
There has been significant progress in the roll out of antiretroviral therapy and food support to people living with HIV. At the end of 2007 around 22,000 people were receiving antiretroviral treatment, up from 3000 in 2004. Current antiretroviral therapy coverage is 26%.
At least 3,966 pregnant women with HIV received anti-retroviral treatment to prevent mother to child transmission of HIV in 2007. The coverage of prevention of mother-to-child transmission programmes increased six-fold from an estimated 6% in 2005 to 32% in 2007.
Key elements of the national response
Lesotho has shown consistent political leadership on HIV and AIDS. Since the declaration of AIDS as an emergency in 2000, the top political leadership has consistently spoken out and supported the AIDS response at the highest level.
At an institutional level Lesotho has embraced the "three ones" principles and has made significant progress toward full implementation. Following a review of the national response from a wide range of stakeholders an updated National HIV and AIDS Policy as well as the National HIV and AIDS Strategic Plan for 2006-2011 and the National Monitoring and Evaluation Plan were approved November 2006.
The National AIDS Commission (NAC), which was set up by an act of parliament in 2005, also became fully functional in 2006. The National HIV and AIDS Policy and the National HIV and AIDS Strategic Plan have set ambitious targets with a view to achieve universal access by 2010. Based on the National HIV and AIDS Strategic Plan, a unified Operational Plan was made for 2007-2008 financial year. Significant progress was also made in securing resources for the implementation of the national strategic plan.
Lesotho has embarked on an accelerated programme to achieve Universal Access by 2010. There has been significant progress on all aspects of the response. Between 2005 and 2007 there have been major advances in the field of policy development as well in increasing programme coverage
The national OVC policy was approved in 2006 with the purpose of providing an enabling environment in which orphans and vulnerable children are adequately cared for, supported and protected.
Key Achievements
Significant gains have been made in the area of HIV testing, access to treatment and prevention of mother-to-child transmission. Lesotho is also significantly poised to launch a comprehensive programme for orphans and vulnerable children.
There are increased new resources available with significant new pledges by the development partners and resources from round 7 of the Global Fund. Through a partnership with the German Development Agency (GTZ) and UNAIDS, the National AIDS Commission has launched a decentralised programme that reaches all the 128 community councils for delivery of an essential package of services.
Key Challenges
The response to HIV is still largely fragmented at the national and district level. The institutionalization of the National AIDS Commission (NAC) in Lesotho is a key achievement towards addressing and coordinating HIV efforts in Lesotho. Some of the main challenges currently faced include: slow progress in achieving behaviour change; low coverage of prevention programmes; limited human resources, especially in the health sector; no proper mechanisms in place to make sustainable and appropriate programmes to mitigate the economic and social impact of HIV and AIDS; increased number of OVC but no clear registration process in place; lack of timely data collection and dissemination; stakeholders not collaborating and coordinating at district and community level and lack of clarity of roles and responsibilities at all levels, and finally the acceptance of NAC as the organization to lead the national HIV and AIDS response
Useful Links
National Strategic Plan
National AIDS Spending Assessment (2005-2008)
HIV Prevention and Modes of Transission Analysis (March 2009)
National AIDS Policy
National Monitoring and Evaluation Plan (2006-2011)
Multiple and Concurrent Partnerships (November 2008)
Male Circumcision - Situation Analysis Report (October 2008)
Guidelines for Implementation of Interventions in the Essential HIV and AIDS Services Package
AIDS Services Package
Delivering as One UN on AIDS
Contacts
UNAIDS Country Office
UN Building
UN Road
Maseru
100
Lesotho
Tel: +26622313790
Fax: +26658884209
National AIDS Commission
Keketso Sefeane
Chief Executive
P.O. Box 11232
4th floor
Post Office Building
Maseru
Tel: +266 22 326 794
Fax: +266 22 327 210
Email: sefeak@lapca.org.ls
Networks of people living with HIV
LENEPLWHA (Lesotho Network of people living with HIV/AIDS)
Bakoena Chele
National Coordinator
Tel/fax: +266 22 327 501
Email: leneplwha@leo.co.ls
Global Report 2008 Data
Source: Epidemiological Fact Sheets on HIV and AIDS, 2008 Update