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Lesotho’s HIV response plan failing
Published
2 years agoon
By
The Post
MASERU – LESOTHO’s HIV response plan is failing to meet the needs of children and adolescents, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) Lesotho has said.
The foundation said this in a press statement following the release of the UNAIDS data report titled ‘In Danger’ ahead of the International AIDS Conference which was held in Montreal, Canada, last week.
EGPAF CEO and President, Chip Lyons, described contents of the report as “a chilling indicator of the damning inequities facing children in the fight for an AIDS-free generation and speaks to the focused efforts still needed to end HIV and AIDS in children globally.”
He said approximately 160 000 children were newly infected with HIV in 2021 – an unconscionable rate equivalent to 430 new pediatric infections daily.
“Nearly 85 percent of these new vertical infections occurred in sub-Saharan Africa,” he said, adding that the data also shows that while children made up 4 percent of all people living with HIV in 2021, they accounted for 15 percent of all AIDS-related deaths globally. As the report states, “we can do better at preventing and treating HIV in children.”
“We must ensure mothers and pregnant women living with HIV can safely and regularly access HIV care services,” he said.
According to the report, almost half of all new HIV infections in children are due to HIV-positive mothers not receiving access to HIV testing services and antiretroviral therapy (ART), and yet, ART coverage for pregnant women living with HIV has not meaningfully improved since 2014.
“Engaging pregnant women in care is a foundational first step to decrease the likelihood of transmitting HIV to their babies, while also protecting their own health.”
Globally, only 52 percent of children who become infected with HIV are accessing HIV treatment services, whereas the same treatment coverage for adults stands at 76 percent.
“A gap that has continued to grow…this is flat out unacceptable and a far cry from the 95-95-95 target goals,” said Lyons.
“We have the best pediatric diagnostic and treatment tools we have ever had in our fight against HIV. Now, we must deploy them to reduce the growing number of new pediatric HIV infections and, by doing so, close the gaps between adults and children.”
According to Lyons, “it is incumbent upon the global health community to step up to this achievable challenge and save the lives of kids impacted by HIV and AIDS. If we are to truly guarantee an AIDS-free generation, the global AIDS response must be laser-focused on addressing these unacceptable inequities by taking deliberate action that prioritises the life of every child at risk of or living with HIV.”
Mosonngoa Motseko of the National Aids Commission (NAC) Lesotho said NAC is mandated with providing strategic leadership and governance, efficient and effective coordination and management of the national multi-sectoral and decentralised HIV and AIDS response towards ending AIDS in 2030.
She said despite Lesotho’s achievement of the 90-97-92 targets towards 90-90-90 in HIV response, she still has some challenges amongst children and adolescents.
The UNAIDS “90-90-90” strategy calls for 90% of HIV-infected individuals to be diagnosed by 2020, 90% of whom will be on anti-retroviral therapy (ART) and 90% of whom will achieve sustained virologic suppression.
“We still have pregnant women with high viral load and this increases chances of infection to infants.”
She added: “New infections in children still persist.”
The Lesotho civil society organisations (CSOs) Priority Charter was developed in 2021 to guide CSOs when advocating for pediatric HIV and TB in the country. One of the most troubling inequalities in the HIV response is the failure to achieve HIV and TB targets, especially those related to children and adolescents.
Despite Lesotho meeting the 90-90-90 targets, the country still lags behind in meeting HIV and TB targets among children and adolescents.
Thus, the CSO’s Priority Charter is expected to kick-start advocacy work to achieve equality in the country’s HIV and TB response plan.
The charter is expected to guide CSOs to ensure that Lesotho closes the gap between pediatric HIV targets and achievements in the HIV and TB response.
’Mapule Motsopa
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MASERU – THE bullets were whizzing past as the Mai-Mai, a ragtag militia fighting for the secession of the diamond-rich Katanga province, pushed their way towards the provincial capital of Lubumbashi.
Their aim was to seize control of Katanga and secede from the central government in Kinshasa in the Democratic Republic of Congo (DRC).
The secessionist conflict, however, soon turned into an ethnic orgy as the Mai-Mai rebels targeted individuals who were not from their own tribe.
Kabeya Kasongo Bruno, a medical doctor based in Katanga at that time and who was from the Kasai ethnic group, quickly realised that he must flee or he and his family would be killed.
Dr Kabeya, together with his wife and six-month old baby, soon packed their bags and left.
Their first port of call was Cape Town, South Africa, a magnet for refugees and migrants in Africa.
That was in 2008.
Dr Kabeya’s stay in Cape Town was soon cut short after xenophobic violence flared up in July of that year.
Feeling extremely unsafe, Dr Kabeya was once again on the run, this time heading north-east to Lesotho.
He applied for refugee status which was quickly granted.
He also got a job at Tebellong Hospital in Qacha’s Nek.
Dr Kabeya who is the vice-predident of the Lesotho Refugee Association, is among the 281 refugees in Lesotho, according to the 2020 statistics from the United Nations High Commissioner for Refugees (UNHCR). About 80 percent of these were from the DRC, while the rest came from Ethiopia, Eritrea and Uganda.
Each of these refugees has a story to tell.
A story of trauma. A story of violent displacement.
And a story of battling economic hardships in a foreign land.
But they also have stories of triumph over hardships.
Stories of defiance. Stories of resilience and a certain resourcefulness and ingenuity in the face of hardships.
That is why instead of waiting for handouts from the government, they have set up small businesses to fend for themselves and provide for their families.
While Lesotho has provided Dr Kabeya and his colleagues in the refugee community with a sense of security and relative freedom, his stay has not been without challenges.
He says when he first arrived in Lesotho in 2008, he could work and travel across the border into South Africa without any hindrances.
The situation however changed about four years ago when South Africa tightened its borders and blocked refugees resident in Lesotho from freely travelling into the country.
Dr Kabeya told thepost this week that as a result of the stringent border controls, refugees who are based in Lesotho can no longer freely cross the border.
“Even when we have medical emergencies, we are no longer able to seek specialist care in Bloemfontein or Johannesburg,” he says.
“It now feels like we are now in a huge, open air prison.”
Dr Kabeya says the South African immigration officials at Maseru Bridge are rejecting the refugee passports and national Identity Cards (IDs) at the border.
“The refugee passports were endorsed by the UNHCR as a travel document and we could travel freely across the border. But not anymore,” he says.
“We have been told that we cannot cross with that passport, which has an R indicating that we are refugees and that we should instead apply for a visa.”
Even when they try to apply for visas, the South African embassy in Maseru is not issuing out the visas.
“We have expressed our concerns to the High Commissioner for Refugees in Lesotho. They have told us that they have taken note of our challenges and will deal with the matter,” he says.
“The South African embassy is refusing to give us the visas and we have not been given any reasons why this is so,” Dr Kabeya says.
“All we are seeking is a right to move freely across the border once one presents their travel documents,” he says.
Dr Kabeya says refugees have children, most of whom were born in Lesotho or came into the country when they were very young.
“These children have aspirations and dreams. They want to further their studies at universities in South Africa but they do not have access to those opportunities. That is why some of us are beginning to think that we are in an open prison,” he says.
Besides the border crisis, most refugee doctors are struggling to register and operate their own private practices. For a doctor to operate in Lesotho, he must first be registered with the Lesotho Medical Council.
“But one can only get that licence if one is working for a hospital run by the Christian Health Association of Lesotho (CHAL) or the government. If you are running your own practice you have to overcome stringent conditions,” he says.
“The Medical Council does not recognise the refugee status and they also don’t see us as expatriates. I have tried to renew my licence for my private clinic in the last year but there has been no answer.”
“All that we are seeking and pleading with the government is recognition (of our refugee status) and be given the freedom to work and run businesses in Lesotho. We also can’t get a loan from banks. They don’t recognise the refugee status,” he says.
Dr Kabeya says when they try to register businesses in Lesotho they still face challenges as they are regarded as refugees under the new controversial Business Licensing and Registration Regulations of 2020 which bar foreigners from operating businesses in certain sectors.
“They are refusing to register our businesses, creating big problems for refugees. Because we are not Basotho it is becoming increasingly difficult for us to own businesses in Lesotho. We understand that the government has other commitments but all we are asking is that we fend for ourselves.”
“We don’t want to rely on the government. We want to look after ourselves.” Dr Kabeya says they have on numerous occasions expressed their concerns to the UNHCR but nothing has changed.
Carbizo Kasuba, is a 40-year-old medical doctor who fled the DRC in 2016.
He too is a refugee in Lesotho.
“I was working at a hospital in the eastern town of Goma in the DRC when rebels from Rwanda stormed the hospital and began shooting indiscriminately. Some of my colleagues were killed in the attack,” Dr Kasuba says.
“I realised I was no longer safe and fled to Uganda.”
The rebels burned the houses, burned the hospital and prison leaving him with deep emotional scars. It took him five years before he was reunited with his wife and child.
Although he feels safe in Lesotho, and is grateful for the hospitality shown by the government of Lesotho, he too is facing major challenges that are unique to refugees.
“When my daughter, who has a serious heart deformity, fell sick I struggled to take her for specialist treatment in Bloemfontein. She was very sick and could have died. I was stuck here in Lesotho until a “Good Samaritan” at the South Africa border intervened,” Dr Kasuba says.
“Refugees elsewhere, like those in South Africa and Mozambique, don’t need a visa to come to Lesotho. They just get their passports stamped and they cross the border. Why us in Lesotho?”
Jessy Shungu, now 32, came to Lesotho from Lubumbashi in the DRC as a 16-year-old boy in 2009. He too was fleeing ethnic clashes in the DRC.
Shungu is running a carpentry workshop, producing and repairing couches in Maseru. But his business is now in distress because he too can’t travel to South Africa to buy stock.
“What is the use of the refugee passport when I can’t cross the border?” he asks.
“We are stuck here in Lesotho. We can’t go anywhere to buy stock.”
At some point he tried to negotiate with the border authorities, an attempt which never worked.
“My passport was destroyed five times at the Maseru border by South African immigration officers. They told me that Lesotho was too small to host refugees,” he says.
Shungu says his father applied and was granted Lesotho citizenship.
“But they refused to give me citizenship. This is just too much for me. At one point I even thought I must commit suicide, things were just too much.”
He says he used to travel and do his business in South Africa without challenges but not anymore.
“I have a child and a wife to take care of but it’s tough. Some have been here for the past 10 or 15 years and they are doctors, serving Basotho. But they are struggling to travel.”
Victor Tshinobo, 57, is a refugee from the DRC who runs a cosmetics business in Lesotho. He used to frequently travel to South Africa to buy his products, until the South Africa government tightened the borders for him.
“Now we have to rely on Basotho who can still freely move across the border to buy stuff for us in South Africa. That arrangement does not always work out well since they sometimes buy inappropriate stuff for us and charge us a high fee for the service,” he says.
“We are prisoners here and no one is intervening on our behalf,” he says.
Deborah Huguette, 39, came to Lesotho from Lubumbashi in the DRC in 2008. She too was a victim of ethnic clashes.
“The rebels from Rwanda were killing my people, the Baluba, in the province of Katanga. They said we were not Congolese and they were attacking us. That is why I fled and came to Lesotho,” she says.
In 2017, she enrolled for a degree in fashion and design at Limkokwing University of Creative Technology. She struggled with the English language but finally made it, graduating from the university in 2021.
But now she can’t get a job. Or start her own business.
Under the Ministry of Trade’s Business Licensing Regulations of 2020, she cannot be allowed to start her own business in the fashion and design sector as such jobs are reserved for Basotho.
“They have told me that fashion and design is reserved for Basotho.”
What keeps her going are odd jobs that she gets from clients. But even when she is trying to make ends meet, she still cannot buy materials in South Africa due to the visa issues as a refugee.
“I am blocked. I can’t travel to South Africa. When I buy the materials here, it is of a very low quality. That is a big challenge.”
“It’s not like Basotho are bad people. They have kept us really well, no xenophobia, it is only these small things that are blocking us that need to be fixed.”
South Africa’s High Commissioner to Lesotho, Constance Seoposengwe, told thepost yesterday that she was not aware of the challenges refugees in Lesotho were facing to cross the border.
“As far as I know, we haven’t received any applications for refugees to transit to RSA via land border,” Seoposengwe said.
“If at the border they want a visitor’s visa endorsed on the passport I think they must present their request to the embassy by applying for a visitor’s visa,” she said.
Seoposengwe said if the refugees are under the Lesotho Commissioner of Refugees, “they normally carry their permission to travel”.
Abel Chapatarongo
MASERU
PROMINENT businessman Bothata Mahlala could be set to challenge a decision by the Democratic Congress (DC) to block him from contesting for the party’s top leadership position, thepost heard this week.
The move comes after the DC national executive committee announced in a circular this week that the position of party leader, currently held by Mathibeli Mokhothu, will not be contested at the elective conference set for January 25 to 27.
Instead, the circular shows that Mahlala will contest for the deputy leader’s position against the incumbent, Motlalentoa Letsosa.
That decision has triggered a fierce response from Mahlala who told thepost yesterday that he was not happy with the party’s decision.
“I am dissatisfied with the decision,” Mahlala said.
“I will announce my next move to the media next week.”
thepost however understands that Mahlala, who has been a prominent funder of the DC over the years, could be seeking legal advice to challenge the national executive committee’s decision which he says is undemocratic and unconstitutional.
That could set the stage for a bruising legal battle within the DC that could leave the party seriously weakened.
Mahlala said the party’s decision to ring-fence Mokhothu’s position smacked of selfishness on the part of the leadership.
Mokhothu’s six-year term as party leader ends this month. He is seeking a new term as party leader.
“Instead of understanding and abiding by the rule of law, he (Mokhothu) claims he is under attack,” Mahlala said.
“I am not against anyone but only want to change Basotho’s lives. No one is fighting him. He is unhappy that some members want changes in the party.”
Mahlala said the party’s grassroots supporters were not happy with Mokhothu’s performance when the DC was in government between 2020 and 2022.
“I am not (interested) in party politics but politics that take the entire nation forward,” he said.
Mahlala said he is being accused of supporting Prime Minister Sam Matekane instead of wholly opposing him as a member of an opposition party.
“I do not support him as a party leader, but as a prime minister for all Basotho,” he said.
The DC’s spokesman, Serialong Qoo, said the circular is “the final decision by party members”.
Qoo took a swipe at Mahlala who he said had gone against the “culture” of the congress parties’ which does not allow members to openly tout for leadership positions without first being recommended from their villages, branches and constituencies.
“The recommendations as they appear in the circular are from the villages, branches and constituencies and were sent to the party head office,” Qoo said.
Qoo said it was wrong for Mahlala to announce to the media that he was going to contest for the leadership of the party even before the party structures had made such a declaration.
“It was also wrong (for him) to badmouth the leader of the party,” he said.
“In the congress movement we wait for the structures to recommend us.”
He said the circular clarifies that “Mahlala and other candidates have accepted the recommendations by the party structures”.
“Our office also has to verify the membership first, before publishing the entire list of contestants,” he said.
Nkheli Liphoto
MASERU
TWO men, who are suspected to be members of a violent syndicate that has been stealing cars in Lesotho, have been arrested.
The two, 23-year-old Molefe Matooane from Mpharane in Leribe and Tumelo Leoatla, 22, of Corn Exchange in the same district, appeared before the Leribe Magistrate’s Court in Tšifa-li-Mali on Monday.
The police said they are looking for three more men in connection with the organised crime.
The two were charged with the murder of Pitso Pitso, 49, on December 14 and the theft of his Honda Fit vehicle.
The court heard that Pitso, a taxi operator, was tricked into believing the two were customers who hired the car to a certain destination unaware that he had been hijacked.
Police say the duo strangled Pitso with a barbed wire until he died and then threw his body into the Nyenye Dam in Maputsoe.
The car was later tracked to South Africa, where it was found with a Mozambique number plate, occupied by four Mozambicans who failed to provide proper documentation.
“The vehicle was found occupied by four Mozambican nationals who failed to provide their documentation,” the police say.
The Mozambicans claimed that they had bought the car from a Lesotho citizen.
“We have the names of that citizen,” the police say.
The police received a tip-off that the syndicate was planning to strike again.
They followed the intelligence and found the two men in possession of a barbed wire, “indicating they were planning to commit another murder”.
The two young men have been remanded in custody and will reappear in court on January 14.
CarSotho, a company importing cars in Lesotho, says several stolen cars and goods were recovered in Lesotho recently.
In a report published last Sunday, the company said Lesotho and South African police collaborated in the search for stolen cars and other goods in Lesotho.
“This development underscores the ongoing challenge of cross-border crime and the importance of coordinated efforts to tackle such issues,” the company said, without specifying how many cars were recovered.
“The recovery operation not only serves as a victory for regional security but also boosts confidence in the ability of authorities to combat organised crime networks operating across borders,” it said.
The company said Lesotho “is often a transit point for stolen vehicles and contraband”.
“Criminal networks exploit the porous border to transport stolen goods, making cross-border cooperation critical to addressing the problem.”
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