LESOTHO has saved 17 109 lives of people living with HIV in 2023 and prevented 1483 new infections in children through Antiretroviral Therapy (ART) and the Prevention of Mother-to-Child Transmission (PMTCT) respectively.
This was revealed by National AIDS Commission (NAC) Monitoring and Evaluation Expert, Ramaema Maema, during a media consultative meeting this week.
The event was also meant to introduce the NAC strategies towards sustainable ways to ensure continued HIV and TB response beyond 2030.
Mr Maema attributed these achievements to the accessibility of ART and the implementation of a test-and-treat strategy, which has provided people with good health outcomes, allowing them to lead healthy lives while living with HIV. He also highlighted that Lesotho's success in preventing 1483 mother-to-child infections was a significant step towards eliminating mother-to-child transmission of HIV. The country has seen a decrease in mother-to-child HIV transmission from 15.2 percent in 2010 to 5.1 percent in 2023.
Another milestone in Lesotho's HIV response, he said, was the recorded decrease in new HIV infections and AIDS-related deaths. Between 2010 and 2023, new infections dropped by 74 percent, and AIDS-related deaths decreased by 47 percent.
"In 2010, new HIV infections stood at 18 520, and in 2023 they were reduced to 4810. AIDS-related deaths in 2023 were 4056; a 47 percent drop from 2010," said Mr Maema.
Discussing mother-to-child infections, Mr Maema noted that reasons mothers infect their children include not taking ARVs during pregnancy and discontinuing treatment after birth, leading to transmission through breastfeeding. He said there was need for increased awareness about the importance of adhering to HIV treatment during and after pregnancy to reduce transmission from mother to child.
Mr Maema also said 95 percent of people living with HIV in Lesotho knew their status, 94 percent were on ART, and 99 percent were virally suppressed. However, challenges remain in ensuring children's adherence to treatment, as it largely depends on their parents and guardians. While 95 percent of children living with HIV know their status, only 80 percent are on ART, and 77 percent are virally suppressed.
"The issue lies with caregivers who do not ensure consistent adherence to treatment, which is necessary for achieving viral suppression," he said.
He further noted that ART access for all ages had significantly increased compared to 2010. In 2010, 94 288 people were on ART, while the number rose to 241 288 in 2023, meaning a 156 percent increase in access.
Mr Maema also pointed out that half of the new infections were among the lower age group of 10 to 24 years.
"Despite the decline in numbers, this indicates that more targeted intervention measures are needed for young people, who are particularly vulnerable to HIV and are getting infected at a high rate. As of 2023, there were 271 396 people living with HIV (PLWHIV) in Lesotho, giving the country an HIV prevalence rate of 18.5 percent, with 4810 new infections reported."
Nonetheless, he said Lesotho had been advised to start strategizing ways to sustain HIV and TB responses until and beyond 2030, ensuring the country can respond to these diseases with or without international support.
For her part, the NAC Chief Executive Officer, Lebohang Mothae, lamented the decline in financial support for HIV programmes in the last three years, with resources being diverted to other diseases, including COVID-19.
"This underscores the need for Lesotho to develop a strategy aligned with its financial capabilities to ensure the country can continue responding to TB and HIV independently if external help is reduced or withdrawn," Ms Mothae said.
She said the decline in HIV support had jeopardised the HIV response and impacted most HIV programs.
"Over the past three years, financial support for HIV decreased by 11.6 percent. However, the government has allocated M233 million to specifically purchase ART for the 2024/2025 financial years.
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"Even international support for HIV, which the country primarily receives from UNAIDS, PEPFAR, and the Global Fund, has been deteriorating. Therefore, the country needs to prepare itself to respond to HIV even if external support is withdrawn.
"We have already mobilised the private sector to explore how we can work together better towards HIV and TB response. We need to strategize better on how we can respond to HIV in a sustainable manner. Global, political, and financial circumstances have changed significantly, and HIV financing is at risk. A paradigm shift is required to revitalise efforts and adopt a new approach to HIV response sustainability," she added.
Ms Mothae said Lesotho had been dependent on external support for too long that if the support got withdrawn, the country might be left vulnerable, hence, the urgent need for a sustainability plan for the HIV response. She expressed confidence that countries, including Lesotho, could end AIDS as a public health threat by 2030. However, she said HIV-related interventions would still be required beyond 2030.
