Lesotho

Key Results in 2022-2023

The Government advanced the introduction of long-acting injectable cabotegravir (CAB-LA) pre-exposure prophylaxis in study settings to curb new HIV infections among adolescents and women.
Integrated HIV and tuberculosis services were scaled up through various actions, such as introduction of point-of-care tests for advanced HIV.
More than 70 000 people residing in drought prone districts accessed integrated HIV education, food security and social protection programmes.
About US$ 71 million was mobilized from the Global Fund for the HIV and tuberculosis response as well as building resilient and sustainable systems for health and community systems strengthening.

Joint Programme Results

In Lesotho, the Joint Programme supported the revision of the National AIDS Strategy (2023-2028) and its implementation of various HIV-related policies, strategies and guidelines improving access and quality of HIV services among children and adolescent girls and young women, and key populations.

Robust advocacy and technical support resulted in the addition of CAB-LA pre-exposure prophylaxis to the list of essential medicines with focus on scaling up this service among adolescents, pregnant and lactating women. Thus, more than 31 000 people accessed CAB-LA (WHO, UNAIDS Secretariat). In addition, over 8.9 million male and over 51 000 female condoms and 123 000 tubes of lubricants were distributed across the country during the 2022-2023 biennium (UNFPA). Integrated HIV awareness creation, food security and social protection programmes also reached more than 70 000 people residing in drought prone districts (WFP).

Lesotho took significant steps in scaling up integrated HIV and tuberculosis services which resulted in increased TB case finding and treatment coverage while strengthening health system resilience through the implementation of the first Integrated Health Sector HIV/TB Strategic Plan. This included integration of point-of-care urine lipoarabinomannan testing among people living with HIV; introduction and scale up of point-of-care tests for advance HIV disease, including CD4 counts; and integration of Advanced HIV Disease (AHD) into primary health care (WHO). Progress was also made towards the elimination of vertical transmission of HIV, syphilis and hepatitis B (UNICEF).

HIV incidence per 1000 uninfected populations

Source: AIDSinfo

AIDS mortality per 1000 population

Source: AIDSinfo

Progress towards 95-95-95 targets

Source: AIDSinfo

Thanks to the Joint Programme’s catalytic support, more than 12 000 people from key populations accessed integrated HIV, sexual and reproductive health and rights (SRHR) as well as sexual and gender-based violence services. More than 15 000 young people improved their knowledge of these topics through in-person and virtual awareness initiatives and a total of 5400 girls in schools received sanitary towels (UNFPA). In addition, over 423 000 learners improved their knowledge and skills of HIV and other sexually transmitted infection, unintended pregnancies and gender-based violence prevention as well as SRHR (UNESCO, UN Women).

Access to gender-based violence, HIV prevention and treatment services as well as data use improved following mentorship and training of healthcare providers, representatives of the National AIDS Council and other implementing partners, including through South-South cooperation (WHO, UNAIDS Secretariat). Gender-based violence, HIV and food security initiatives helped leverage the influence of faith leaders and men to change harmful gender norms; integrated HIV prevention services and male engagement programmes were implemented in male clinics, workplaces, cattle posts and transport stations (UNICEF). A community training manual was also developed to support efforts aimed at eliminating harmful practices and foster positive gender norms in collaboration with 132 men from 10 district platforms (UN Women). In addition, 53 law enforcement officers, prosecutors, lawyers and government representatives improved their capacity of implementing the Counter Domestic Violence Act 2022 through a training of trainers (UN Women).

Community-led HIV monitoring was integrated into the national healthcare quality assurance mechanisms; and communities were trained in implementing and coordinating various monitoring modalities to ensure people-centred HIV services. Results from community-led HIV monitoring have been used to improve quality of facility-based services, reduce persisting disparities in access to treatment and guide supportive supervision and mentorship at central level (UNAIDS Secretariat).

More than US$ 71 million was mobilized from the Global Fund Grant Cycle 7 for the HIV and tuberculosis response as well as building resilient and sustainable systems for health and community systems strengthening.