‘We’re committed to rolling back HIV’

‘We’re committed to rolling back HIV’

Staff Reporter

MASERU – ON December 1 Lesotho joined the rest of the world in commemorating World AIDS Day. Despite efforts by the Ministry of Health and development partners to keep the virus at bay Lesotho is now ranked the second highest country in terms of HIV prevalence.
Is there any bright future in the fight against the pandemic? thepost last week spoke to Health Minister ’Molotsi Monyamane and the US Ambassador Matthew Harrington on the extent to which the war is being won. Below are excerpts from that interview.

How far are you with fight and the extent to which you can say we have had an impact?


The government of Lesotho and the United States of America have had a 50-year journey. This started with the Peace Corps volunteers and the school feeding programme. They had a big impact, especially in maths and science in high schools in the 70’s because it was clear from then that the young people are to be empowered with tools to get formal training.

People are born with skills and talents but they can be trimmed with formal teaching.
In the health sector, America has been massively supporting us. In 2004 the Clinton Foundation helped the Ministry of Health to set up systems for diagnosis, care and treatment of HIV-related diseases as well as procurement of medicines.
We are one of the 50 countries that bought medicines as a pool procurement at a good price through the negotiation with the Clinton Foundation.
The ARV’s were very expensive at that time, people were dying.

Then came the Global Fund, and within the Global Fund (there are) a lot of NGOs which are supported by the US government, which is the biggest contributor.
Another contributor is PEPFAR (the US President’s Emergency Plan for AIDS Relief) which was introduced by President Bush.
It contributed a lot more to the health system with their support of skills transfer and finance.
Also the US’s (Millennium Challenge Account) MCA supports 135 clinics. We were able to strengthen the health system.
We still have to make sure that those facilities are maintained and that we build other facilities even in human resources through the CDC. We are getting support in laboratories to get best labs services.

Our collaboration is important and it shows that the fight is not done by one party but it’s a team effort. The United States has been your partner for 50 years of independence.
Lesotho celebrated 50 years and we have used the opportunity to reflect on what has taken place in our partnership. In 2017 the Peace Corps will be celebrating 50 years of uninterrupted presence in Lesotho, and are planning a big celebration.
They work in the 10 districts, teaching math and science in high school and English in primary schools. On average there are over 90 Peace Corps and they make a real impact on our communities.

I have talked to people in government and out of government, Basotho from all walks of life and it is always a positive impact. We are proud of the legacy.
MCC (Millennium Challenge Corporation) grant ended in 2013 and we see the impact of the collaboration — 135 clinics.
There are 500 Basotho in exchange programmes who are studying in the United States on programmes paid for by the US government and many more paying for themselves.
That is the Young African Leader Initiative programme formed by President Obama.
Now let’s talk about PEPFAR, which is by far the biggest in terms of resources that we commit to Lesotho. It is a sign of bipartisan support for what we do for Africa.
As we get into a new administration, many people ask if such programmes are going to continue. US engagement in Africa has had a strong bipartisan support for a long time. PEPFAR has been here since 2007.

We have spent about US$300 million in nine years. That’s a lot of money. Globally PEPFAR used US$70 billion. We have contributed about a third of the Global Fund.
Now let’s talk about the progress made.

Let me start by congratulating the government of Lesotho. I think the government has shown leadership and has taken a number of steps in addressing the epidemic.
One is the test and treat, where you would only be given treatment when your CD4 count was low, some people never came back.
In June the government launched the test and treat programme to put people on treatment when they found they were positive.
That is really important. It was not an easy decision because it has financial implications because you pay for more test kits and ARVs.
In terms of leadership you have His Majesty, the Prime Minister and the First Lady talking about it.
Everyone is speaking on a regular basis on the impacts of HIV. Surely you don’t want to be number one or number two in HIV prevalence. This is another way of being innovative on how to get tested.
You used to have people having problem getting back to get treated after being tested.

On PEPFAR, we have now launched a machine that will tell if there is a virus in the body. The machine will be launched in Mafeteng district.
This machine will help a lot in the paediatric section. It is for children. Once a baby has been tested and is found to be HIV positive, that baby will now be on treatment immediately.
Before we had this machine, it was not easy to treat the patients because some were not traceable once they tested positive. For example, people are very mobile.
A person would be staying in Motimposo today and tomorrow is staying in Ha-Hoohlo and such ones do not always go back to clinics for check-ups.
The aim here is to eliminate HIV by 2030. It was done in Cuba and other countries and they now have no new infections despite that they have few resources.
The old way of testing but not immediately treating had a devastating impact. For example, that way of operating did not show if a person was on treatment or not. It only showed that they were tested.

Our programme is to have as many Basotho tested as possible. That really is the thrust of the programme.
We support 121 facilities that we work in. We support about 17 000 staff on the ground. We need those people on the ground.
In order to get 80 percent of Basotho treated we are looking at the way we can have many people tested and treated. We supported about 600 000 people to be tested until this year.
That’s a lot of people. We supported the testing of 43 000 people for the viral load this year alone.
The impact of test and treat, we have seen a miracle. About 42 percent were under treatment and within a year that number shot up to 57 percent in the districts we are working in.

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