By Thoboloko Ntšonyane
MASERU- There have been amplified calls for the Lesotho young people to champion strategies that blend technology and education in response to the crisis of the HIV prevalence in the country.
Data show that Lesotho continues to grapple with the highest HIV prevalence rates globally. With over 20% of the adult population living with HIV, it is further reported that approximately 59% of persons with Tuberculosis (TB) in Lesotho are co-infected with HIV.
Lesotho continues to face significant challenges in combating TB, being one of the highest incidences globally. According to data available, the country has a TB incidence rate of 661 cases per 100,000 people, ranking among the worst-affected nations. While case-finding efforts have increased from 32% in 2020 to 47% in 2023, approximately 60% of cases remain undiagnosed, hindering the country’s ability to meet national and global TB eradication targets by 2030.
This crisis is compounded by TB’s status as a leading cause of death among people living with HIV.
It has been reported that women continue to bear the brunt of HIV infections, with a prevalence rate of 23.5%, compared to 13.4% among men. While these figures represent a decline from 2010 to 2023, they remain a cause for concern.
However, the youth of Lesotho are emerging as the vanguard in this fight, bringing innovative solutions, lived experiences, and a fresh perspective to the forefront.
This emerged during the consensus meeting for the Sustainability Roadmap for the HIV and TB Response last week at Thaba-Bosiu senior leadership of the country, government officials, development partners, civil society organizations (CSOs) had convened.
Young women and adolescent girls reportedly face unique vulnerabilities. Many are child-headed breadwinners, forced into transactional sex due to poverty.
As one young advocate pointed out, Nthabeleng Ntšekalle said: “It takes a confident and empowered girl to negotiate protected sex, especially with older partners.” Financial insecurity leaves many unable to assert their rights, exacerbating the risk of HIV transmission.
For young men and women already living with HIV, stigma remains an enduring obstacle.
One young man, name withheld, shared his struggle to enter into relationships after disclosing his HIV status, highlighting the social attitudes that continue to perpetuate fear and stigma.
“Openness is key,” he said. But he noted that it’s hard when people still look at a positive person as a problem.
The youth have then proposed bold solutions.
From advocating for peer-led interventions involving young nurses to integrating digital services into healthcare, their vision is reshaping
the fight against HIV.
By prioritizing platforms like the Wi-Fi spots in places that young people frequent, they advocate that this move will meet the youth where they are most comfortable. They said in such places service providers can easily reach young people.
Simplifying the health system and integrating HIV and TB services also featured prominently in their vision for sustainability.
Ntšekalle pointed out that tackling stigma and ensuring access to information are paramount.
The youth advocated for community engagement, equipping parents with accurate knowledge about preventive tools like Pre-exposure Prophylaxis (PrEP), and fostering open dialogues that break traditional taboos with parents are essential.
She also said there is a need for collaboration with academic institutions as they are hubs of knowledge and can engage in research for solutions. Such efforts, she said will combat recurring challenges, such as drug stock-outs at health centres.
Lesotho still faces the road ahead and demands innovative approaches to maintain these gains.
UNAIDS Country Director, Pepukai Chikukwa warned that despite the progress, HIV remains a pandemic, compounded by declining resources.
“It’s been four decades, yet it is still a pandemic.” She stressed the importance of sourcing local funding to reduce dependency on external donors.
Meanwhile, the government has signaled its commitment to the HIV and TB response, with the Deputy Prime Minister, Justice Nthomeng Majara said there are plans to allocate more resources toward sustainability.
Similarly, the Speaker of the National Assembly,Rt Hon Tlohang Sekhamane urged Parliament to lead discussions on reforming laws to address these issues effectively. He said legislators as people’s representatives should lead conversations around issues of sustainability and review and reform laws to ensure their responsiveness.
Lesotho’s Sustainability Roadmap highlights the need for a progressive legal framework that champions human rights, long-term investments in health.
The fight against HIV in Lesotho is at a pivotal juncture. Youth are no longer just participants in this battle; they are its leaders. They represent the future as they embody the resilience, courage, and innovation needed to overcome the greatest health challenges in Lesotho, HIV and TB.