PRINCETON, New Jersey — Lesotho, a landlocked country surrounded by South Africa, is a lower middle-income nation currently confronting a major health crisis — the HIV/AIDS epidemic. Approximately 21% of the country’s adults aged 15–49 have HIV or AIDS — the second-highest adult prevalence rate in the world. This epidemic is highly concentrated in sub-Saharan Africa. Since its first identification in the ’80s, HIV and AIDS have spread widely across the region. Developing countries are particularly susceptible, as high rates of poverty and low incomes hinder access to protection, testing and adequate medical care.
Although Lesotho’s economy has experienced growth in recent years, the nation is still considered a developing country. As of 2023, 56.2% of the population lives below the lower middle-income rate of $3.20 per day, resulting in high rates of poverty, particularly in rural areas. Consequently, these regions have limited access to basic infrastructure and services, including health care, which worsens the impact of HIV/AIDS in Lesotho. This epidemic is a major health concern, particularly among disadvantaged people in the nation. Here are three organizations working to alleviate its impact across the country.
MOSAIC
In 2021, the United States Agency for International Development (USAID) announced the implementation of a new $85 million global project, Maximizing Options to Advance Informed Choice for HIV Prevention (MOSAIC), which helps women protect themselves from HIV. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) funded this project through USAID; it will operate for five years, from 2021 to 2026.
MOSAIC aims to identify new biomedical prevention products for HIV and increase women’s access to these products. While the project operates in many countries, it is primarily concentrated in sub-Saharan Africa, the region with the highest rates of HIV in the world. MOSAIC focuses almost exclusively on women. According to USAID, HIV prevalence is much higher among adolescent girls than boys of the same age range: in many affected regions across sub-Saharan Africa, four in five new HIV infections in people aged 15–19 occurred in women as of 2021. The project thus concentrates its efforts on reducing the disproportionate share of women who contract HIV by increasing their access to prevention products.
MOSAIC partners with health programs across the region to achieve its goals. These include LVCT Health, an organization based in Kenya; Wits Reproductive Health and HIV Institute, based in South Africa; and Jhpiego, a nonprofit organization affiliated with Johns Hopkins University. MOSAIC works worldwide, Jhpiego works specifically in Lesotho to promote equity of health and address the HIV epidemic. As the leader of project implementation in Lesotho, Jhpiego has helped more than 103,000 Basotho people learn of their HIV status and supported the Lesotho Nursing Council in introducing a more effective and sustainable HIV/AIDS response.
Lesotho Planned Parenthood Association
The Lesotho Planned Parenthood Association (LPPA) is a branch of the International Planned Parenthood Federation (IPPF). A global nongovernmental organization, IPPF aims to provide health care to people in need and advocate for sexual and reproductive health and rights. Given the severity of HIV/AIDS in Lesotho, LPPA’s efforts are mostly concentrated on HIV prevention and treatment.
The organization specifically aims to provide sexual health care to disadvantaged people in Lesotho, many of whom do not have access to prevention products, testing or treatment. It manages sexually transmitted infections, distributes contraceptives and offers voluntary testing.
LPPA has an extensive presence throughout Lesotho. It is currently accessible to clients through 10 permanent clinics, nine private providers, 30 associated agencies, 90 peer educators and 14 community-based distributors. To promote sexual health care and education, especially among Lesotho’s young population, LPPA hosts discussions, health talks and workshops. It also reaches out to teachers and leaders to promote effective education and legislation on sexual health.
AHF Lesotho
The AIDS Health Foundation (AHF), a global nonprofit, also provides HIV care and services to those in need. AHF Lesotho, a branch of the organization, works through local partnerships to provide health care to Lesotho’s population.
AHF Lesotho started in two districts—Maseru and Leribe. After operating for more than eight years, it has expanded to cover five out of Lesotho’s 10 districts. As of October 2022, the organization has 43,063 patients in care. They work closely with the Lesotho Network of People Living with HIV in health facilities to increase testing and counseling for patients.
The organization also runs youth programs for adolescents with HIV. Their work includes increasing access to medical treatment. Furthermore, they encourage young women to take preventative measures against STIs and unplanned pregnancies.
Looking Ahead
These organizations are but three of many efforts to combat HIV/AIDS in Lesotho. All have made significant progress in reducing the impacts of the epidemic, especially in disadvantaged regions. Prevalence rates, however, remain high. Supporting organizations like these is the first step to a healthier Lesotho.
– Lana Swindle
Lana is based in Princeton, NJ, USA and focuses on Global Health and Politics for The Borgen Project.
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