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The healthcare system in Lesotho is grappling with a significant setback after approximately 1,500 health workers were let go following the abrupt suspension of aid by the United States. The suspension affects critical programs funded by USAID and PEPFAR, addressing major public health issues like HIV/AIDS and tuberculosis.
Minister of Health Selibe Mochoboroane confirmed the dire situation, stating that the Lesotho government is actively working on interim solutions and securing financial aid to bridge the gap. A task force led by the Finance Ministry aims to allocate R27-million to cover the salaries of affected personnel.
The impact of the aid suspension extends beyond the workforce disruption. The US has been instrumental in supporting Lesotho’s healthcare through programs aimed at TB treatment and prevention, HIV/AIDS management, including prevention of mother-to-child infections, and HIV testing, along with maternal health services. PEPFAR's contribution is particularly notable as it has significantly aided in keeping 240,000 Basotho on antiretroviral treatment in a country with one of the highest HIV prevalence rates globally.
Prime Minister Sam Matekane highlighted the longstanding partnership between the United States and Lesotho, emphasizing the crucial role US aid has played. However, the recent executive orders issued by President Donald Trump suspending financial assistance for 90 days have jeopardized numerous life-saving initiatives.
In response to the crisis, the health ministry has taken immediate steps such as recalling health workers on leave and inviting health students and graduates to volunteer. Meanwhile, the US embassy in Maseru, through spokesperson Moeketsi Chefa, indicated difficulties in responding to media inquiries due to ongoing consultations with Washington.
The situation leaves several US-funded organizations, like the Elizabeth Glaser Pediatric AIDS Foundation and Jhpiego Lesotho, in a challenging position, with employees sent home and projects winding down. Moreover, the Millennium Challenge Account Lesotho's Health and Horticulture Compact, valued at US$300-million, faces an uncertain future with a recent work stoppage announcement.
Long-term strategies proposed by the government, such as introducing health insurance to stabilize funding, are still in the nascent stages. The potential withdrawal of PEPFAR funding poses a significant threat to the national health agenda, potentially reversing years of progress in disease prevention and treatment.
As Lesotho's leaders scramble to devise a sustainable health system, thousands of health workers and patients face an anxious wait for solutions before reaching a systemic breaking point.