Lesotho Makes Significant Progress against HIV

By Adebowale Bello. Freelance Health Writer.

Monday, September 2, 2024. Lesotho has made remarkable advancements in its battle against HIV, saving 17,109 lives of people living with the virus in 2023 through Antiretroviral Therapy (ART). The country also prevented 1,483 new infections in children, thanks to the effective implementation of the Prevention of Mother-to-Child Transmission (PMTCT) program.

These achievements were highlighted by Ramaema Maema, an expert with the National AIDS Commission (NAC) during a media meeting this week. The meeting also served as a platform to introduce NAC's strategies aimed at ensuring a sustainable HIV and TB response well beyond 2030.

Mr. Maema attributed the success to the widespread accessibility of ART and the implementation of a test-and-treat strategy, which has enabled people living with HIV to achieve better health outcomes. He emphasized that the prevention of 1,483 mother-to-child infections marked a significant milestone toward the elimination of mother-to-child HIV transmission in Lesotho. Notably, the country has seen a reduction in mother-to-child transmission rates from 15.2% in 2010 to 5.1% in 2023.

Lesotho has also recorded substantial decreases in both new HIV infections and AIDS-related deaths. Between 2010 and 2023, new infections fell by 74%, while AIDS-related deaths dropped by 47%. Specifically, new HIV infections declined from 18,520 in 2010 to 4,810 in 2023 and AIDS-related deaths in 2023 stood at 4,056.

Addressing the issue of mother-to-child transmission, Mr. Maema pointed out that lapses in treatment adherence, such as mothers not taking ARVs during pregnancy or discontinuing treatment post-birth, are leading causes of transmission through breastfeeding. He called for heightened awareness about the importance of maintaining HIV treatment during and after pregnancy to reduce transmission risks.

Mr. Maema further disclosed that 95% of people living with HIV in Lesotho are aware of their status, 94% are on ART and 99% have achieved viral suppression. However, challenges remain, particularly in ensuring adherence to treatment among children, which heavily depends on their caregivers. Although 95% of children living with HIV know their status, only 80% are on ART and 77% have reached viral suppression.

He noted that access to ART has significantly improved across all age groups compared to 2010. The number of individuals on ART rose from 94,288 in 2010 to 241,288 in 2023, marking a 156% increase in access.

However, Mr. Maema expressed concern about the high rate of new infections among young people aged 10 to 24 years, who accounted for half of the new cases in 2023. As of 2023, 271,396 people were living with HIV in Lesotho, resulting in a prevalence rate of 18.5%, with 4,810 new infections reported.

Despite these achievements, Mr. Maema stressed the need for Lesotho to develop strategies to sustain its HIV and TB responses beyond 2030, particularly in the face of dwindling international support.

NAC Chief Executive Officer, Lebohang Mothae, expressed concern over the decline in financial support for HIV programs over the past three years, with resources being reallocated to other diseases, including COVID-19. 

"This situation highlights the urgency for Lesotho to devise a strategy that aligns with its financial realities to ensure continued responses to TB and HIV, even if external assistance is reduced or withdrawn," Ms. Mothae stated.

She added that the 11.6% decline in HIV funding had jeopardized several HIV programs, but the government has earmarked M233 million for ART procurement in the 2024/2025 financial year. However, international support from organizations like UNAIDS, PEPFAR, and the Global Fund has also been diminishing.

Ms. Mothae stressed that Lesotho must mobilize the private sector and adopt a new approach to HIV response sustainability, given the changing global, political, and financial landscapes. She underscored the need for a paradigm shift to rejuvenate efforts and ensure the long-term sustainability of HIV response programs.

While Ms. Mothae expressed optimism that AIDS could be eradicated as a public health threat by 2030, she acknowledged that ongoing HIV-related interventions would be necessary beyond this target date to maintain control over the epidemic.

Source: Lesotho Times

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Published: September 2, 2024

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