Thabang Leseteli (left) is a pre-exposure prophylaxis (PrEP) client who is happily married to Nthatisi Moleko (right) who has been on antiretroviral treatment since 2016. To stay safe and healthy, the couple is supported by PEPFAR through mothers2mothers. Photo by Thom Pierce
By Rebecca E. Gonzales
After two successful Lesotho population-based HIV Impact Assessments (LePHIA)—in 2016 and 2020—Mission Lesotho was able to gain a better understanding of how the people of Lesotho are engaging with HIV care and treatment services. In late 2020, Ambassador Rebecca E. Gonzales stood alongside Her Majesty Queen ‘Masenate Mohato Seeiso, Embassy Maseru’s LePHIA survey patron, to announce that Lesotho had exceeded the United Nations Program on HIV/AIDS (UNAIDS) 90-90-90 targets, achieving 90-97-92. The 2020 survey found that 90% of persons with HIV in Lesotho have been diagnosed; 97% of those diagnosed are on treatment; and 92% of those on treatment are virally suppressed, meaning they will not transmit the infection to others as long as they continue to control their virus by staying on treatment. As Lesotho achieves these important milestones to taking complete control over the HIV/AIDS epidemic there, the embassy team continues to support the country’s efforts. With support through the PEPFAR office in Lesotho, bilateral efforts remain steadfast in America’s bid to help reverse the impact of the HIV/AIDS epidemic in the Mountain Kingdom.
Even in the face of the global COVID-19 pandemic, and a period of incredible strain on the country’s health systems, Lesotho’s government ensured the continuity of lifesaving treatment for people living with HIV/AIDS. They demonstrated great agility in adapting service delivery and realigning available HIV/AIDS resources to support the country’s efforts to manage COVID-19 locally. Across this nation, PEPFAR-supported public health, clinical care, and laboratory platforms have been vital in the ongoing fight against the novel coronavirus.
Lirontšo Mohlomi is a DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored, and Safe) public-private partnership beneficiary at a PEPFAR-funded Population Services International satellite site in Maseru. She is survivor of sexual abuse and has been receiving comprehensive DREAMS services to empower and support her in recovery journey. Photo by Thom Pierce 
Malikeleko Raqhoe, 18, is a member of the PEPFAR-supported Elizabeth Glaser Pediatric AIDS Foundation Teen Club for young people living with HIV at the Pointman Health Center in Pitseng, Leribe. Photo by Thom Pierce 
Marethabile Mohloai is a member of the Bolokanang Basotho Community Adherence Group that is supported by PEPFAR through the Lesotho Network of AIDs Services Organizations to encourage adherence to antiretroviral treatment. Photo by Thom Pierce 
Mpho Molise is a peer educator for female sex workers in Maseru. She assists them with access to HIV prevention and treatment services that are offered with support from PEPFAR through Care for Basotho and other partners. Photo by Thom Pierce 
A PEPFAR-supported healthcare worker administers the COVID-19 vaccine to a local citizen. Photo by Elizabeth Glaser 
Mokolokolo Ntlhangoe is a voluntary medical male circumcision (VMMC) beneficiary. He received VMMC services at the Emmaus Health Center in Matelile, Mafeteng with PEPFAR support through Jhpiego. Photo by Thom Pierce
Looking forward, the U.S. is working to maintain its robust partnership with key health partners to bolster the individual and community-level actions essential to bilateral success in controlling the HIV/AIDS epidemic in the Kingdom of Lesotho. Supporting proven and credible scientific discoveries in the fight against HIV, such as Undetectable equals Untransmittable (or U=U), means that people with HIV who achieve and maintain an undetectable viral load—the amount of HIV in the blood—by taking antiretroviral therapy daily as prescribed cannot sexually transmit the virus to others and are no longer considered infectious. Disseminating credible messages on U=U will ensure that the many years of progress and lifesaving health services PEPFAR Lesotho and others have put in place to change the HIV narrative in Lesotho is maintained. Preventing new HIV infections remains the primary goal of the PEPFAR Lesotho program, particularly as Lesotho remains on track to achieve the UNAIDS 95-95-95 targets and ultimately end HIV/AIDS as a national health threat.
Embassy leadership visited all ten districts of Lesotho, experiencing first-hand PEPFAR’s impact on ordinary citizens. Courageous Lesotho citizens—men and women, boys and girls—are championing the race to respond to HIV and AIDS by addressing stigma and other socioeconomic cultural barriers. Some are Lesotho citizens who contracted HIV during the time that diagnoses were perceived to be death sentences, but they are alive today and continue to lead healthy lifestyles by adhering to their antiretroviral drugs. They are married, have not infected their loved ones, and have children who are free of HIV. These are the true champions and pioneers of U=U.
Recently, the embassy team launched a photo campaign to profile these success stories. They traveled to districts outside of the capital city of Maseru to meet with PEPFAR Lesotho beneficiaries, health partners, and community-led organizations who have worked to keep Lesotho on track to being AIDS-free.
Embassy Maseru will continue to empower local institutions to ensure the full range of HIV prevention and treatment services are owned and operated by Lesotho citizens. In collaboration with the Ministry of Health, their local partners will continue to direct HIV service delivery and establish sufficient capacity, capability, and durability to ensure successful engagement and impact because HIV/AIDS epidemic control in Lesotho remains within their reach.
Rebecca E. Gonzales was the ambassador to the Kingdom of Lesotho.
