…As Lesotho Faces Risk of ARV Shortage

21 March 2025 by Pascalinah Kabi

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A total of 804 health workers in Lesotho have lost their jobs following the suspension of HIV funding by the US administration in January 2025.

According to a statement from UNAIDS on the impact of US funding cuts on HIV programs in Lesotho, more than half of the health workforce supported by the United States President’s Emergency Plan for AIDS Relief (PEPFAR) has been affected.

“Of the 1,508 human resources for health supported through PEPFAR funding, 804 (53.3 percent) are currently terminated,” read the statement.

Meanwhile, the World Health Organization (WHO) has warned that Lesotho is at risk of running out of antiretroviral (ARV) medication in the coming months, which could disrupt treatment for people living with HIV. The Ministry of Health reports that 240,152 people in Lesotho rely on ARVs.

On March 17, 2025, WHO told the media that the suspension of most PEPFAR funding had led to an immediate halt in HIV treatment, testing, and prevention services across more than 50 countries.

“Eight countries now have substantial disruptions to antiretroviral therapy and some will run out of medicines in the coming months.”

“But currently, the countries that we are most worried about those eight are countries that you would know as well as being very… they are re also very at risk for other outbreaks, infections, and emergencies, including Haiti, Kenya, Lesotho, South Sudan, Burkina Faso, Mali, Nigeria, and Ukraine. 

“All of them, we are working with teams to see how we can avert challenges in the future. But next week, the list may be different. So please take the list as an indicative list that is not the final.”

In January 2025, the Ministry of Health’s Principal Secretary, ‘Maneo Moliehi Ntene, told Uncensored News that Lesotho’s drug supply remains largely secure. She emphasized that the government funds the majority of essential medicines, including HIV treatment.

“Yes, it’s true there is a small portion that is being bought by partners, but more than 80 percent, we buy them as a country. So, we should not panic too much,” Ntene stated.

“We are going to prepare ourselves to close that gap to ensure that the government purchases all the medication fully.” 

Aside from job losses and a potential ARV crisis, the UNAIDS March 17, 2025, statement indicates that projects targeting key populations, voluntary medical male circumcision, pre-exposure prophylaxis (PrEP), major treatment and care initiatives, and health systems strengthening remain suspended due to the US foreign funding freeze.

“Overall, approximately 28 percent of PEPFAR support has resumed, 32 percent is still paused and 40 percent is terminated.”

UNAIDS says the Ministry of Health is leading a task team to assess affected projects and explore mitigation measures. These include government funding for essential staff salaries, task shifting, recalling staff on leave, and integrating health workers’ roles.

“The immediate priorities of the Ministry of Health and National AIDS Commission are to ensure commodity security, to lead and coordinate through convening task team meetings and expediting development of Part B of the HIV and TB Sustainability Roadmap,” read the UNADS statement.

Additionally, the Ministry of Health has submitted a contingency budget to the Ministry of Finance and Development Planning to cover critical staff salaries at the government pay scale for three months.

“For the medium term, the government and partners are waiting until the end of the US Government review period (April 20) to make significant funding allocation decisions.”

The statement indicated that the United Nations (UN) is working with the National AIDS Commission and Ministry of Health to expedite development of HIV and TB Sustainability Roadmap Part B, with preparatory and analytical work while awaiting the global guidance.