4 April 2008, Maseru -- In 2004, Lesotho became one of the first countries in the world to launch a nationwide effort to test its entire population for HIV. The initiative was introduced as the ‘Know Your Status Campaign’ (KYS). The objective of the campaign, which was co-ordinated by the Ministry of Health and Social Welfare (MOHSW), and supported by partners such as the United Nations (UN), mainly WHO, UNICEF and UNDP, was to ensure that all Basotho over the age of 12 years be offered an HIV test by end of 2007.

Lesotho is a nation afflicted by one of the world’s worst HIV epidemics, with a prevalence of over 23% of people aged 15-49 years. Many public health experts have warned that with a population of barely 1.8 million people, AIDS threatens the very existence of this Basotho Kingdom. Such is the current crisis that life expectancy has dropped from over 55 to just 35 years of age since 2000.

In a groundbreaking move for the Kingdom’s healthcare, His Majesty King Letsie III of Lesotho became the first monarch to support such a campaign by launching the KYS’s operational plan on 1st December 2005. The initiative started with the Right Honourable Prime Minister (PM) Mr. Phakalitha Mosisili taking the bold step to test publicly in 2004. Their gestures have been critical in reducing the stigma still associated with HIV. They have also demonstrated political will and leadership to defeat the scourge of the pandemic and unite the people of Lesotho to contribute to their own and ultimately their country’s survival.

A joint KYS review by the Government of Lesotho (GoL) and partners such as the UN and the Centre for Disease Control was carried out during February-April 2008. The aim of the review was to assess the outputs of the KYS campaign and make recommendations for future actions.

The recently released KYS review reveals that while only 50,000 people in Lesotho knew their HIV status in 2004, by the end of 2007, over 240,000 Basostho tested for HIV. About 30% of HIV tests were conducted in community based settings, providing access to HIV Testing and Counselling (HTC) and referrals which were not previously available in remote villages. At the inception of the initiative only 4 Anti Retroviral Therapy (ART) centres were established in country. To date over 107 ART centres are operational.

“A milestone in ensuring a supportive legal environment for the expansion of HTC services, while protecting people’s rights, has been the development and dissemination of the HTC policy in Lesotho”, said the Principal Secretary of the MOHSW, Mr. T.J. Ramotsoari.

Another key achievement has been the enormous demand for HIV testing, created by the KYS campaign, as a result of the intensive community social mobilisation activities, making KYS a household word.

Authorities at the onset of the campaign hoped that the programme would initiate a “national conversation” on AIDS, reaching out to every village chief and community leader. Through KYS about 3,500 community health workers were train to carry out tests, while 3,600 counsellors were recruited to offer support and encourage people to find out their HIV status.

The KYS review cites the campaign as having a visible and tangible effect at both national and community levels, especially in reducing stigma and increasing knowledge of HIV and AIDS.

“The level of acceptance and the number of people coming forward for testing amidst fear and discrimination has been impressive with over 95% of people counseled accepting to take the test. While stigma, fear and discrimination used to keep people as far as possible from clinics or HTC centres, now we see people flooding in to be tested for HIV. ” said the KYS manager from Berea district during the release of the KYS review.

One major challenge exposed by the KYS review was the prevalent resource gap in terms of effectively implementing all aspects of the campaign. Limited funding hampered effective capacity strengthening of community based service providers. Another critical mention was that HIV care and treatment components of the KYS campaign overshadowed prevention aspects. 

“The campaign was a proactive move to reach people with life saving care, treatment and support services at a critical time. HIV prevention interventions have been parallel efforts to the KYS activities. In future, integration of all these components will trigger a more holistic approach” said the Director General for Health Services, Dr. Moteetee, speaking on behalf of the Minister of Health and Social Welfare.

The findings of the KYS review, uncovered a general recognition of the KYS being a successful entry point for accessing HIV services at all levels. A recommendation was tabled to introduce a second phase of the campaign building on lessons learned and catalyzing increased integration of activities, resource mobilization and coordination at all levels.

“The UN family will continue to support the GoL in its endeavours to prevent and control HIV. We can assure you that as the UN family we will collectively review and address the recommendations made today and continue supporting this commendable initiative, which Lesotho turned inot its MDG 1 priority” stated Mr. Bhim Udas, WFP Lesotho Country Director, speaking on behalf of the UN in Lesotho.

For more information, please contact:

Mpoetsi Mothibeli – Ministry of Health and Social Welfare Communication Officer
e-mail: mmothibeli [at] yahoo.co.uk

Clelia Barbadoro – UNICEF Lesotho, Communication Officer
e-mail: cbarbadoro [at] unicef.org

Peter Phori – WHO Lesotho, Info/health Promotion Officer
e-mail: phorip [at] ls.afro.who.int