page_title: HIV/AIDS in Lesotho
section_title: 2000-2010
hierarchical_section_title: HIV/AIDS in Lesotho / National response / 2000-2010
caption_attribution_description: English: Community health workers receive training in Lesotho.
context_page_description: HIV/AIDS in Lesotho constitutes a very serious threat to the Basotho people and Lesotho's economic development. Since its initial detection in 1986, HIV/AIDS has spread at alarming rates in Lesotho. In 2000, King Letsie III declared HIV/AIDS a natural disaster. According to the Joint United Nations Programme on HIV/AIDS in 2016, Lesotho's adult prevalence rate of 25% is the second highest in the world, following Eswatini.
  HIV has affected the majority of the general population, while disproportionately affecting the rural, working-age population. The spread of HIV in Lesotho is compounded by cultural practices, serodiscordancy, and gender-based violence. Lack of developed sexual education programs in schools places the young demographic at increased risk of HIV infection.
  Over the past three decades, the Government of Lesotho, in collaboration with global organizations such as The Global Fund to Fight AIDS, Tuberculosis and Malaria, World Health Organization, and President's Emergency Plan for AIDS Relief, has dramatically improved HIV testing and treatment coverage through comprehensive program implementation.
context_section_description: LAPCA was established in 2001 to coordinate the multisectoral response to HIV/AIDS, but several factors hindered it in fulfilling its strategic role. In October 2003, the government used Turning a Crisis into an Opportunity, a document constructed by a Lesotho-based United Nations interagency group, as an official working model to address the epidemic. In 2005, the government passed a bill establishing the semi-autonomous National AIDS Commission (NAC) and National AIDS Secretariat (NAS) to coordinate and support strategies for the period 2005 to 2008.
  Lesotho committed itself to the World Health Organization (WHO) goal of having 28,000 people on antiretroviral therapy (ART) by the end of 2005. In May 2004, the first comprehensive HIV/AIDS center to provide ART opened. The Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund), international private organizations, local and international nongovernmental organizations (NGOs), and community-based organizations (CBOs) provided the mainstay of the response to HIV/AIDS, especially in the area of community mobilization. Most of these operations were small and localized to specific geographical areas in urban centers. The biggest challenge was the establishment of national networks and civil society organizations on HIV/AIDS, most importantly among people living with HIV/AIDS and within the NGO network. In 2005, the apparel and textile industry, Lesotho's biggest private employer, established an innovative sector-wide and comprehensive HIV workplace program through a public private partnership with the government of Lesotho, buyers, employers, and other donors. In May 2009, the Apparel Lesotho Alliance to fight AIDS (ALAFA) provided close to 90% of the 42,000 employees with prevention services, and up to 80% with treatment services.
  Lesotho has increasingly used community mobilization and education, as well as offering HIV testing and counseling (HTC) upon individual request. The burden of determining how and when people access treatment and counseling services is placed on local communities. Communities are responsible to ensure confidentiality and provide access to post-test services. In 2004, only 2.7% of Basotho adults participated in HTC. However, HTC participation increased to 35% by 2011.
caption: Community health workers receive training in Lesotho.
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