Lesotho Project History

2006 – At the beginning of the year, PIH is invited by the government of Lesotho and the Clinton HIV/AIDS Initiative to launch a project to bring HIV treatment and quality primary care to mountainous, rural areas. A team is assembled headed by Dr. Jennifer Furin (country director) and Dr. Salmaan Keshavjee (deputy country director) and a Lesotho partner organization is formed – Bo-Mphato Litšebeletsong tsa Bophelo. In June and July, PIHL begins training Village Health Workers and treating patients at Nohana, the first of 10 mountain clinics serviced by the Lesotho Flying Doctors Service and Mission Aviation Fellowship. By the end of the year, nearly 200 patients are receiving antiretroviral therapy (ART) at the Nohana Health Center and more than 450 are enrolled in pre-ART care.

2007 – The Rural Initiative expands to three more mountain health centers – Bobete, Nkau and Lebakeng. By December, over 8,600 patients have been tested for HIV since the program began. 30 percent of those tested, over 2,700 patients, are HIV positive, and PIHL is treating more than 1,200 of them with lifesaving ARVs. In addition, more than 500 cases of TB have been diagnosed and treated in the rural clinics - more than 82% are co-infected with HIV. With funding from Open Society Institute (OSI) and in partnership with the Ministry of Health, PIH launches Lesotho’s first-ever treatment program for multidrug-resistant tuberculosis (MDR-TB). The PIHL team renovates the national TB laboratory, Maseru TB Clinic, and turns an old leprosy hospital into a stat- of-the-art MDR-TB hospital, complete with a negative air pressure system to aid in infection control. By late December, 43 patients have been diagnosed and have started the arduous treatment for MDR-TB.

2008 – The Rural Initiative expands to Tlhanyaku and Methalaneng, bringing comprehensive health care at a total of six facilities serving a population of more than 300,000 people. Confronted by an alarming increase in the number of malnourished children, with help from the government of Ireland, PIHL launches a supplementary feeding program to provide nutritional support to all malnourished children in the areas served by the Rural Initiative mountain health centers. The MDR-TB program is now treating patients in all 10 districts of Lesotho. To date, not a single patient has defaulted from the arduous two-year course of treatment.

2009 – The Rural Initiative begins working in a seventh remote mountain clinic in Manamaneng. Partnering with the Ministry of Health, PIH Lesotho trains healthcare staff throughout the country on treating MDR-TB and MDR-TB/HIV co-infection. All patients with suspected MDR-TB in Lesotho are referred for treatment and the program has become a beacon for other sub-Saharan countries looking to implement MDR-TB treatment; to date, the program has provided training for medical professionals from Ethiopia, South Africa, Swaziland, and Tanzania.