A patient waiting to be seen at one of PIH Lesotho's mountain clinics.

A man living in the rural mountains of Lesotho.

Each year, millions of people around the world celebrate their fortieth birthday, but in places like Lesotho, where—during the last decade—the average life expectancy has fluctuated between 35-40, many people do not reach this milestone. In fact, Lesotho has one of the lowest life expectancy rates in the world, ranking 191 out of 195 countries.

Approximately one quarter of the country’s adult population is HIV-positive, and life expectancy in the tiny mountain kingdom—home to just under 2 million people—has plummeted since HIV entered the country in the 1980s. In addition, Lesotho’s people are being ravaged by a second epidemic, tuberculosis (TB). Lesotho’s TB rate is the fourth highest in the world, and people whose immune systems have been weakened by HIV are especially vulnerable to the disease. Approximately 76 percent of TB patients in Lesotho are co-infected with HIV. While people who reside in Lesotho’s major cities live, on average, to about 40, people residing in rural Lesotho—where PIH primarily works—are less likely to reach that marker. Consequently, nearly 20 percent of children living in Lesotho have lost their parents to either HIV or TB.

A group of Partners In Health (PIH) supporters—all bound by a common birth year, 1970—are working to change these statistics. These activists, many of who have never met in person, include journalists, academics, writers, and concerned parents. Together, they have launched the Gift of 40 Campaign.

“The inspirational idea to do something good and socially significant to mark our fortieth birthdays first came from Professor Sree Sreenivasan,” says Sujatha Bagal, a Washington, DC-based writer. “He sent out an e-mail and tweeted—very mysteriously—to ask if people who were turning 40 this year would be interested in joining him and working together on a project,” said Sujatha. Sreenivasan, Dean of Students at the Columbia University Graduate School of Journalism, received hundreds of responses.

“Of that group, eight people came together to form an informal steering committee,” continues Sujatha. “Ivan Dominguez suggested that we who are fortunate enough to be celebrating our fortieth birthdays this year, and who expect to live nearly as many years longer, must do something in Lesotho.”

“I immediately began to think about what turning 40 meant and, specifically, whether there were places in the world where people could not expect, on average, to see their fortieth birthday,” recounts Ivan, who is Assistant Director of Public Affairs and Communications for the National Association of Criminal Defense Lawyers. “I found three countries, all in Sub-Saharan Africa, where the life expectancy did not exceed 40. Lesotho…is one of them.”

In the mountains of Lesotho, the average life expectancy is less than 40 years old.

“It was right in front of me—turning 40 is a real gift, hence the birth of the moniker, ‘Gift of 40,’” says Ivan. “What better way to mark turning 40 than to share work to share it.”

The group’s goal is simple. Instead of having friends buy cards and gifts for their fortieth birthdays, they are asking 40 family members, friends, and coworkers to each donate $40 to the Gift of 40 Campaign. If 400 people persuade 40 people in their lives to donate $40 to PIH's work in Lesotho, the campaign will have raised $640,000. The admirable goal is a life-changing amount of money for communities in rural Lesotho.

      What $640,000 can do in Lesotho:

  • Support maternal health initiatives at 7 remote mountain clinics for 3 years
  • Support 1 remote mountain clinic for a full year
  • Fund 1,000 community health workers and MDR-TB treatment supporters for more than a year

PIH’s catchment area in Lesotho is estimated at 300,000 – 350,000 people, though it is difficult to break down how many are served by ten clinics. PIH launched its project in Lesotho in 2006, following an invitation from the government of Lesotho. We also worked in close consultation with the Clinton HIV/AIDS Initiative, our partners in Rwanda, to determine where to replicate that successful comprehensive care model in Africa.

“The Gift of 40 is nothing more than a coalition of people like you spreading the word to our networks, and their networks, about the dire situation in Lesotho and encouraging people to give directly to PIH's Lesotho Project,” reads the group’s website. “It is our hope and aim that, in the coming years, the people of Lesotho will be living healthier, longer lives, and we can focus our attention there on the Gift of 50.”

Join the Gift of 40 challenge.

Visit the Gift of 40 Blog.

Learn more about PIH’s work in Lesotho.