MR. PRESIDENT

EXCELLENCIES

DISTINGUISHED GUESTS

LADIES AND GENTLEMEN,  

THE 2003 GENERAL ASSEMBLY HIGH-LEVEL MEETINGS ON HIV AND AIDS OFFER A UNIQUE OPPORTUNITY FOR US TO ASSESS PROGRESS IN THE  IMPLEMENTATION OF THE DECLARATION OF COMMITMENT ON HIV AND AIDS; AND TO REAFFIRM PREVIOUS COMMITMENTS ON HIV AND AIDS. 

MR. PRESIDENT, HIV AND AIDS HAVE EMERGED AS THE GREATEST OBSTACLE TO THE DEVELOPMENT OF OUR NATIONS AND, INDEED, TO THE ATTAINMENT OF THE MILLENNIUM DEVELOPMENT GOALS (MDG).  MY COUNTRY, LESOTHO, IS ONE OF THE SIX COUNTRIES IN SOUTHERN AFRICA AFFECTED BY THE HUMANITARIAN CRISIS FUELLED BY POVERTY, UNEMPLOYMENT AND HIV AND AIDS. WITH AN HIV AND AIDS SERO-PREVALENCE RATE OF 31% AMONG ADULTS, LESOTHO IS THE FOURTH MOST SEVERELY AFFECTED COUNTRY IN THE WORLD.  

THE GOVERNMENT IS VERY CONCERNED THAT DESPITE VARIOUS EFFORTS TO CURTAIL THE SPREAD OF THE PANDEMIC, INFECTION RATES CONTINUE TO RISE AND HAVE REACHED CRISIS PROPORTIONS.  THE GOVERNMENT HAS DECLARED HIV AND AIDS A NATIONAL DISASTER AND HAS CONTINUED TO USE EVERY OPPORTUNITY TO EXHORT ALL TO DO EVERYTHING IN THEIR POWER TO HELP CONTROL AND MANAGE THE PANDEMIC. 

THE GOAL OF THE GOVERNMENT IS TO REDUCE HIV AND AIDS PREVALENCE IN THE 15-49 AGE GROUP FROM THE CURRENT 31% TO 25% BY THE YEAR 2006. TO THIS END, THE NATIONAL STRATEGIC PLAN 2002/2003-2004/2005 IS BEING REVIEWED TO SHIFT THE NATIONAL RESPONSE FROM THE HEALTH SECTOR TO A MULTI-SECTORAL AND MULTI-STAKEHOLDER PARADIGM. THIS WILL PROVIDE FOR A MORE EFFECTIVE FRAMEWORK FOR COORDINATING THE NATION’S RESPONSE TO HIV AND AIDS, AND MAINSTREAMING INTERVENTIONS INTO THE WIDER NATIONAL DEVELOPMENT PROGRAMMES THROUGH THE LESOTHO AIDS PROGRAMME COORDINATING AUTHORITY (LAPCA).  IN FACT GOVERNMENT IS SERIOUSLY CONSIDERING A PROPOSAL TO TRANSFORM LAPCA INTO A SEMI-AUTONOMOUS NATIONAL COMMISSION ESTABLISHED AND MANDATED BY LEGISLATION. 

THE PRIMARY FOCUS IN PREVENTION HAS BEEN ON COMMUNICATION AND EDUCATION FOR BEHAVIOURAL CHANGE, PARTICULARLY FOR THE YOUTH.  PEER EDUCATORS, ESPECIALLY YOUTH AND HIGH RISK GROUPS, INCLUDING HERDBOYS, CONTINUE TO BE TRAINED IN “HELP OTHERS TO CHANGE THEIR BEHAVIOUR” INITIATIVES.  ADOLESCENT HEALTH CORNERS HAVE BEEN ESTABLISHED TO MEET THE REPRODUCTIVE HEALTH CARE NEEDS OF ADOLESCENTS. 

TO PREVENT HIV TRANSMISSION THROUGH BLOOD TRANSFUSION, THE CURRENT HEALTH CARE POLICY ENSURES THAT BLOOD DONORS ARE SCREENED FOR HIV AND HEPATITIS B THROUGH INTERNATIONALLY ACCEPTED STANDARDS, AND ONLY NON-REACTIVE BLOOD IS TRANSFUSED. 

A MAJOR CONSTRAINT IS THAT ONLY A FEW HOSPITALS CURRENTLY MAINTAIN VOLUNTARY COUNSELLING AND TESTING (VCT) FACILITIES.  EVEN WHERE SUCH FACILITIES EXIST, THEY ARE USED MAINLY FOR BLOOD DONATION SERVICES AND CONFIRMATION OF HIV DIAGNOSIS FOR PATIENTS ATTENDING STI CLINICS.  THE INTRODUCTION AND SCALING UP OF VCT IS A VERY IMPORTANT INTERVENTION FOR BEHAVIOUR CHANGE.  

GETTING TESTED AND KNOWING ONE’S STATUS IS THE KEY ELEMENT IN BOTH PREVENTIVE AND TREATMENT REGIMES.  THE GOVERNMENT, THEREFORE, PLANS TO INCREASE THE NUMBER  OF SITES THAT OFFER VCT SERVICES FROM THE CURRENT FIVE TO THIRTY BY 2007. 

THE GOVERNMENT IS ALSO PROVIDING SERVICES FOR PREVENTION OF MOTHER-TO-CHILD TRANSMISSION (PMTCT) OF HIV.  GUIDELINES ON PMTCT SERVICES AND INFANT FEEDING HAVE BEEN DEVELOPED, AND HEALTH WORKERS ARE BEING TRAINED TO SUPPORT THE SERVICE.  PMTCT IS ACHIEVED THROUGH INCREASING ACCESS OF WOMEN OF CHILD-BEARING AGE AND THEIR PARTNERS TO HIV PREVENTION SERVICES, REPRODUCTIVE HEALTH AND FAMILY PLANNING SERVICES; AND PROVIDING PREVENTIVE ANTIRETROVIRAL DRUGS, ELECTIVE CAESAREAN SECTION AND REPLACEMENT FEEDING. 

A MAJOR CHALLENGE CONCERNING TREATMENT OF THOSE INFECTED WITH HIV IS CREATING  ACCESS TO AND PROVIDING ANTIRETROVIRAL TREATMENT DRUGS.  IT IS ENCOURAGING TO NOTE THAT THROUGH THE GLOBAL FUND, ACCESS TO ANTIRETROVIRAL DRUGS WILL BE INCREASED TO ENSURE THAT THOSE WHO NEED TREATMENT, RECEIVE IT.  HOWEVER, LIMITATIONS OF TRAINED PERSONNEL, PHYSICAL FACILITIES, SUCH AS LABORATORIES AND EQUIPMENT, REMAIN OUR BIGGEST CHALLENGES. 

 THE ANNUAL BUDGET  ALLOCATION TO THE MINISTRY OF HEALTH INCREASED FROM 7% OF THE TOTAL GOVERNMENT  RECURRENT  BUDGET IN 2000 TO 9% IN 2002.  IN ADDITION, THE GOVERNMENT ALLOCATES 2% OF THE ANNUAL RECURRENT BUDGET OF EACH MINISTRY TO FINANCE THE FIGHT AGAINST THE HIV AND AIDS PANDEMIC.  HOWEVER, WITH THE RISING HIV INFECTION RATES AND THE INCREASING NUMBER OF ORPHANS, THIS IS BUT A DROP IN THE OCEAN.  THE ISSUE OF FINANCIAL RESOURCES IS OUR BIGGEST IMPEDIMENT AND NEEDS URGENT ATTENTION OF THE GOVERNMENT OF LESOTHO AND OUR COOPERATING PARTNERS. 

TRAINING OF VARIOUS GROUPS IN HOME-BASED CARE, HAS BEEN UNDERTAKEN, AND COMMUNITY HOME-BASED CARE KITS HAVE BEEN PROVIDED TO SUPPORT GROUPS THROUGHOUT THE COUNTRY IN COLLABORATION WITH THE OFFICE OF THE FIRST LADY, LAPCA, RELIGIOUS BODIES AND SEVERAL NGOS. 

MR PRESIDENT, THE IMPACT OF HIV AND AIDS ON FAMILIES SIGNIFICANTLY REDUCES ECONOMIC STATUS AND PERPETUATES POVERTY.  FOOD SECURITY AND NUTRITION ARE THREATENED AND THE NUMBER OF ORPHANED AND OTHER VULNERABLE CHILDREN IS ON THE INCREASE.  CURRENTLY THERE ARE AN ESTIMATED 73 000 ORPHANS UNDER 14 YEARS OF AGE IN THE COUNTRY.  GIVEN THEIR EXTREME VULNERABILITY, IN THE ABSENCE OF PRIMARY CARE-GIVERS, SUCH CHILDREN, ESPECIALLY GIRLS, DROP OUT OF SCHOOL AND ARE OFTEN EXPOSED TO EXPLOITATION AND OTHER FORMS OF ABUSE. 

THE EXTENDED FAMILY SYSTEM THAT WAS SO CENTRAL TO THE LIVES OF BASOTHO IS BECOMING DISFUNCTIONAL. CONSEQUENTLY, IT IS NO LONGER A RELIABLE STRUCTURE IN THE CARE OF ORPHANS AND VULNERABLE CHILDREN.  INCREASINGLY THERE ARE MORE CHILD-HEADED FAMILIES AS WELL AS THOSE HEADED BY THE ELDERLY.  HELP SHOULD THEREFORE BE EXTENDED TO THESE SUPPORT STRUCTURES TO AVOID OVERSTRETCHING AND OVER-BURDENING THE CARE-GIVERS. THERE ARE CURRENTLY NINE INSTITUTIONS THAT PROVIDE CARE TO 935 ORPHANS AND VULNERABLE CHILDREN.  THIS IS MINIMAL COMPARED TO THE ESTIMATED NUMBER OF ORPHANS. 

THE OFFICE OF THE FIRST LADY AND THE MINISTRIES OF EDUCATION AND TRAINING AND OF HEALTH AND SOCIAL WELFARE REGISTER CHILDREN WHO CANNOT AFFORD SCHOOL FEES THROUGHOUT THE COUNTRY.  THESE RECEIVE  BURSARIES TO ENSURE THAT THEY ATTEND SCHOOL.  THE INTRODUCTION OF FREE PRIMARY EDUCATION BY THE  GOVERNMENT HAS ALSO INCREASED ACCESS TO PRIMANY EDUCATION FOR CHILDREN INCLUDING OVC.  CLEARLY THE PROBLEM GOES BEYOND ACCESS TO EDUCATION.  IT HAS TO DO WITH MORE MATERIAL AND BASIC NEEDS SUCH AS DAILY BREAD, CLOTHING, HEALTH CARE, LOVE AND SUPPORT. 

MR PRESIDENT, WE ARE AWARE THAT IT IS EASY TO BE OVERWHELMED BY THE SCALE OF THE HIV AND AIDS PANDEMIC, THE SUFFERING ASSOCIATED WITH IT, AND THE CONTINUING INCREASE IN NEW HIV INFECTIONS. HOWEVER, IT IS NOW A KNOWN FACT THAT HIV INFECTION IS PREVENTABLE,  AND THE PANDEMIC CAN BE TURNED AROUND.  IT IS POSSIBLE TO MAKE A DIFFERENCE.  INFECTION RATES CAN BE CURTAILED.  THOSE WHO ARE ALREADY AFFECTED CAN BE HELPED TO LIVE LONGER AND BETTER QUALITY LIVES.  SOME OF THE NEGATIVE EFFECTS OF THE PANDEMIC CAN BE PREVENTED OR MINIMISED.  THERE ARE REPORTS, FROM THE REGION AND ELSEWHERE, OF SUCCESSES AND BEST PRACTICES IN CHANGING BEHAVIOUR, REDUCING NEW INFECTIONS AND MITIGATING THE IMPACT OF THE PANDEMIC.  THERE ARE ALSO IN-COUNTRY REPORTS OF FAMILIES, GROUPS OF INDIVIDUALS AND COMMUNITIES WHICH ARE SUCCESSFULLY CONFRONTING THE EPIDEMIC.  THE CHALLENGE IS TO SCALE UP AND REPLICATE THESE SUCCESSES THROUGHOUT THE COUNTRY, AND FOR THIS WE NEED RESOURCES. 

FOLLOWING THE RECENT SADC EXTRAORDINARY SUMMIT ON HIV AND AIDS, WHICH LESOTHO WAS PRIVILEGED TO HOST, LIKE THE REST OF THE SADC REGION, LESOTHO REAFFIRMS HER COMMITMENT TO COMBATING THE HIV AND AIDS PANDEMIC IN ALL ITS MANIFESTATIONS.  THROUGH THE MASERU DECLARATION, ADOPTED BY THE  SADC SUMMIT AS A WORKING DOCUMENT, LESOTHO IS COMMITTED TO AN AGGRESSIVE RESPONSE TO THE HIV AND AIDS PANDEMIC THROUGH MULTI-SECTORAL PROGRAMMES TARGETING THE FOLLOWING PRIORITY AREAS: 

1.      PREVENTION THROUGH EDUCATION AND SOCIAL MOBILISATION.  THIS INCLUDES INTENSIFYING THE PROVISION OF REPRODUCTIVE HEALTH SERVICES TO YOUTH, MEN AND WOMEN; SCALING UP PROGRAMMES FOR PREVENTION OF MOTHER-TO-CHILD TRANSMISSION OF HIV AND SCALING UP THE ROLE OF EDUCATION IN PARTNERSHIP WITH ALL KEY STAKEHOLDERS; 

2.      IMPROVING CARE, ACCESS TO COUNSELLING AND TESTING SERVICES AND TREATMENT AND SUPPORT.  THIS ENTAILS STRENGTHENING HEALTH CARE SYSTEMS, FACILITATING EXPANSION OF WORKPLACE PROGRAMMES ON HIV AND AIDS, SUPPORTED BY APPROPRIATE POLICIES AND LEGISLATION; EXPANDING ACCESS TO VOLUNTARY COUNSELLING AND TESTING; INCREASING ACCESS TO AFFORDABLE ESSENTIAL MEDICINES INCLUDING ANTIRETROVIRAL THERAPY USING FUNDS FROM NATIONAL BUDGETS AND FROM THE INTERNATIONAL COMMUNITY; INVESTING IN NUTRITION PROGRAMMES AND PROMOTING USE OF LOCALLY AVAILABLE FOODS AND TRADITIONAL MEDICINES; 

3.      MITIGATING THE IMPACT OF HIV AND AIDS BY CREATING AN ENVIRONMENT CONDUCIVE TO GENDER-BALANCE; STRENGTHENING HOME-BASED CARE PROGRAMMES, NUTRITIONAL AND PSYCHO-SOCIAL SUPPORT; STRENGTHENING AND SUPPORTING COMMUNITY EFFORTS TO IDENTIFY AND PROVIDE FOR OVC; AND 

4.      INTENSIFYING RESOURCE MOBILISATION BY IMPLEMENTING THE ABUJA DECLARATION ON INCREASING ANNUAL NATIONAL BUDGET ALLOCATIONS TO THE HEALTH SECTOR; STRENGTHENING THE INVOLVEMENT AND PARTICIPATION OF ALL STAKEHOLDERS TO CONTRIBUTE TOWARDS FINANCING HIV AND AIDS PROGRAMMES. 

MR. PRESIDENT, THE GOVERNMENT OF LESOTHO HAS ALREADY TAKEN POSITIVE STEPS TO ADDRESS THESE CHALLENGES.  A STRATEGY DOCUMENT, “STRATEGIES FOR SCALING UP THE FIGHT AGAINST HIV AND AIDS IN LESOTHO” IS BEING FINALISED; AND PROCESSES FOR THE RESTRUCTURING AND REVITALISATION OF LAPCA TO STEER THE INTENSIFIED RESPONSE TO THE PANDEMIC, HAVE BEEN INITIATED.  THE POLITICAL WILL IS VERY STRONG. WHAT WE NEED ARE RESOURCES AND CAPACITY-BUILDING.  BUT THAT WE HAVE NO CAPACITY, AS WE HAVE BEEN TOLD AD NAUSEAM, CANNOT AND MUST NOT BE USED AS AN EXCUSE FOR DENYING US RESOURCES.  IT IS AS ABSURD AND RIDICULOUS AS TELLING A NEIGHBOUR WHOSE HOUSE IS ON FIRE THAT HE/SHE HAS NO WATER AND THEREFORE YOU ARE NOT ABLE TO HELP.  NOT VERY BRILLIANT, IS IT?  

I  THANK  YOU