Lesotho is beginning to experience the painful effects of a decision by United States President Donald Trump to defund programmes to support HIV/AIDS initiatives in Africa.
In an internal memo seen by this newspaper this week, the Director General Health Services in the Ministry of Health, Dr Makhoase Ranyali, told clinicians and professionals dealing with HIV/AIDS to start rationing supplies for anti-retroviral medication.
She spoke of ARVs “stock levels that are negatively impacting implementation of 6-12 month ART dispensing”.
Health services providers were directed to “reinforce strict adherence to the ART multi-month dispensing guidance as prescribed in the 2022 National Guidelines on the use of ART for HIV prevention and treatment”.
While this was an internal memo for the Ministry of Health it helps unmask the huge crisis Lesotho is facing in seeking to contain and manage the HIV/AIDS crisis in the face of Trump’s decision to cut funding for HIV/AIDS programmes in Lesotho.
This is the first time we are beginning to see the true impact of Trump’s decision to defund AIDS programmes under the United States President’s Emergency Plan for AIDS Relief (PEPFAR), a global agency set up in 2003 to fight AIDS.
The memo confirms that we have a problem on our hands. That is the reality.
The message Trump sent two months ago was that we are on our own as Basotho. The days of relying on foreign governments to pay for some of our basic needs are now over.
In order to deal with this new reality, Lesotho will need to craft a new long-term, sustainable strategy that ultimately weans ourselves from foreign interests.
We can’t rely on the Americans. We can’t rely on the Chinese either. We are basically on our own.
In the face of depleting ARVs supplies, it has become critical for Lesotho to ration the drugs. We hope and pray that the supplies will not be reduced to a month’s supply which would increase the chances of HIV patients defaulting on their medication.
If that were to happen, we will run the risk of seeing an increase in drug resistance which would result in a rebound in infections.
The result would be a serious reversal of the gains we have achieved in the fight against HIV/AIDS over the past 20 years.
That would be tragic.
Experts in the medical field inform us that treatment of HIV/AIDS to achieve viral suppression is critical in the fight against the pandemic.
And that those who consistently take their medication and whose immune systems have succeeded in suppressing the viral load do not pass on the virus.
Such treatment has allowed hundreds of thousands of Basotho who are on HIV/AIDS treatment drugs to lead productive lives, thanks to the PEPFAR programme.
Lesotho must prioritise on finding solutions to this crisis triggered by the US’ decision to cut funding.
An AIDS Levy, to which every employee in the public and private sector contributes, could help build a “war chest” to deal with the shortfall.
The government must take over the research and treatment programmes for HIV/AIDS that were being spearheaded by NGOs.
It must harness the skills and distribution channels that had been set up by the NGOs. All that work that was being done by the organisations must not be allowed to go to waste even if some of these organisations might eventually fold.
We cannot afford a break in the supply chain. The NGOs have the expertise on how to distribute the medication and the government must make use of these to improve its distribution channels.
The testing of HIV was also being spearheaded by NGOs. They drove the HIV campaigns, educating the masses on how to prevent infections and the need to enroll for treatment for those who were infected.
The onus now lies with the government to take up the baton and run with it.
