WHO applauds Lesotho Prime Minister for leading universal voluntary HIV testing drive
Hundreds of Basotho villagers in the remote mountainous region of Qachas Nek packed themselves into the Community Hall to witness The Right Honourable Prime Minister of Lesotho, Pakalitha Mosisili, submit himself to an HIV test to launch the Know Your Status Campaign that the government of Lesotho has initiated as one of its strategies for scaling up the national response to the HIV/AIDS pandemic in Lesotho.
Lesotho is the first African country to initiate Universal Voluntary Counselling and Testing (UVCT), and only the second country in the world, after Brazil, to do so. Lesotho has the forth-highest HIV/AIDS prevalence rate in the world, estimated at 30%, indicating the need for urgent and bold action.
Although all Principal Secretaries and other senior government officials numbering more than 200 people have already been tested in January 2004, the PM wanted to return to his home village to be among his friends and family, as close as possible to his community, to receive pre-test counselling, and have a blood sample taken for testing. In a unexpected move, while the gathering expected their respected leader to be first to present himself to the counselling nurse to have the procedure explained, before the blood specimen was taken, it was the Catholic Archbishop of Lesotho the Very Reverend Bernard Mohlalisi who was first in the queue. “When things are hard, the parent usually takes the lead. Since the Archbishop is our spiritual father, he has offered to go ahead of me, to give me encouragement by his example” the Prime Minister explained. After a few minutes of private counselling, the health staff carefully explained to the Archbishop that the blood specimen would be identified with a code, which would be written on a slip of paper and given to the person being tested, so that the results could be accurately matched with each person.
Reassured, the Prime Minister took off his jacket and rolled up his sleeve, to be next. Amid loud applause and joy, he announced that in the same way as he had been tested, his wife and himself had agreed to take the nation into their confidence once the result of the test was known. “The notion of shared confidentiality is more suitable to the HIV and AIDS context in Lesotho, where as more and more Basotho know their status, they will be more able to care for and support one another, as well as protect themselves and their partners, and thereby break down the walls of secrecy and denial, which feed the social stigma and discrimination,” he stated.
Turning to the wider implications, the Prime Minister challenged all Heads of Government and National Leaders to take the test, and set an example that inspires their people to take steps to know their status, and thus break down the stigma and fear that is proving more devastating than the disease itself.
Dr Miguel Kiasekoka, WHO Representative to Lesotho, and chair of the Lesotho UN theme group on HIV/AIDS remarked that the PM’s actions would go down in history as something unique. “This is not only a great day for Lesotho, but for the World,” he said. “For a political leader to be willing to identify himself so directly with the plight of his people is remarkable. With Universal Voluntary Testing we will be able to know how to better manage the pandemic and make best use of the medical and technical interventions now available to treat people with HIV/AIDS, and to mobilise resources effectively to achieve the three strategic aims of the initiative.” (1. All those who are negative should remain negative. 2. All those who are positive should have long and productive lives; and 3. Improve the quality of life for all Basotho.)
Today it is possible to talk confidently about Universal Voluntary Testing because nutrition and treatment options, that allow those who are positive to live longer and more productive lives, are available. Lesotho only has 2 laboratory units that test the CD 4 count and viral load of HIV positive people. WHO is assisting the Ministry of Health and Social Welfare to acquire and position another 4 laboratory units at various health facilities, so that at least 28,000 people in Lesotho receive ARV by 2005, as part of WHO’s Global initiative to ensure 3 million people receive ART by 2005.
“Despite the reduced cost of ARVs this medication is still going to be expensive in the Lesotho context of food insecurity and poverty” Dr Kiasekoka explained. “WHO is determined that ART must reach those most in need of it, not just those who can afford it. This means that the public health system needs to be strengthened and developed overall. The Prime Minister has ensured the “Know Your Status” campaign commences where it should – with the people in situations of greatest vulnerability, and with the least resources.”
A WHO HIV/AIDS technical officer from the ‘3 by 5’ initiative arrives in Lesotho shortly to advise how best to ensure the target of 28,000 people most in need of ART receive it, and to ensure the practicality of treatment given the particular constraints that Lesotho faces.
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