Basotho, alongside civil society organisations, looked to their government for reassurance and a concrete plan of action following the United States’ decision to pause external funding.
However, the anticipated response was notably absent from the budget speech delivered on Wednesday.
The ongoing crisis, affecting several nations, including Lesotho, has dominated global headlines as countries outline their mitigation strategies.
While the Ministry of Health acknowledged the funding pause, many expected the government to address the matter comprehensively during the budget speech, an expectation that went unmet.
Minister of Finance and Development Planning, Retšelisitsoe Matlanyane, announced in her budget speech for the 2025/26 fiscal year that donor grants had declined by six percent, while donor loans had dropped by five percent compared to the 2024/25 period.
“This financial outlook reflects a resource gap of M739.8 million for the government,” she stated.
A day before the budget presentation, Boshepha Ranthithi, Director of the Lesotho Network of People Living with HIV and AIDS (LENEPWHA), voiced civil society’s concerns.
Ranthinthi emphasised the need for the budget to support sustainable prevention programs developed in collaboration with stakeholders.
“We hoped to see allocations for short- to medium-term interventions, especially considering the involvement of Members of Parliament,” Ranthithi said. He stressed that clear financial commitments would demonstrate the country’s dedication to its HIV/AIDS goals, ensuring that Lesotho does not remain vulnerable to external funding decisions like the recent US pause.
For the 2025/26 fiscal year, the health sector has been allocated M3.1 billion, prioritising efforts to reduce morbidity and mortality rates while advancing universal health coverage.
Matlanyane highlighted that this budget aligns with Lesotho’s Extended National Development Strategy (NSDP II) 2023/24–2027/28, with a Primary Health Care (PHC) approach as the foundation of service delivery.
“Our goal is to ensure that health services are accessible, comprehensive, and community-driven,” she stated. “This requires focused efforts to reduce the prevalence of tuberculosis (TB), HIV/AIDS, and chronic non-communicable diseases like hypertension and diabetes, while simultaneously strengthening healthcare infrastructure.”
She also reaffirmed the government’s commitment to comprehensive HIV/AIDS prevention, testing, and treatment, particularly for vulnerable populations such as children and men.
“We have made significant progress, but challenges remain. Our priority is to enhance outreach and education efforts to close the gaps and build on the success of our treatment programs,” she said.
However, Matlanyane did not outline a clear government strategy to sustain HIV/AIDS prevention and testing services, a critical area affected by the US funding pause.
The absence of a response in the budget speech drew sharp criticism from Members of Parliament.
MP Machesetsa Mofomobe, who is also the leader of the opposition Basotho National Party (BNP) described the US decision as a crisis requiring urgent financial intervention, expressing shock that the budget speech did not acknowledge it.
“This should have been addressed to reassure the nation that despite the US decision, the government has its own plan. The silence is shocking,” Mofomobe said.
MP Remaketse Sehlabaka criticised the budget, arguing that it failed to address the country’s pressing challenges. Sehlabaka also expressed concern over potential job losses resulting from the funding pause.
“If the US government decides to fully withdraw funding after the 90-day period, Lesotho could face a severe crisis, possibly with devastating consequences, including the loss of lives,” he warned.
As a member of the Social Cluster, Sehlabaka pledged to push for a formal discussion on the health budget and the funding shortfall before the Ministry of Health’s budget is presented to the National Assembly.
Makhalanyane Mokhothu, Chairperson of the Social Cluster Committee, affirmed the committee’s responsibility to ensure the issue is included in the Ministry’s plans.
However, Mokhothu neither confirmed nor denied reports that health posts in hard-to-reach areas are at risk of closure due to the funding pause.
“The US funding supported many of these facilities, covering salaries for nurses, counselors, laboratory technicians, and pharmacy staff. If funding is cut, the disruptions could lead to health post closures, creating a significant void in essential services,” he stated.
Ntsoaki Motaung is an award-winning health journalist from Lesotho, specializing in community health stories with a focus on sexual and reproductive health and rights, as well as HIV. She has contributed to platforms like “Be in the KNOW,” highlighting issues such as the exclusion of people with disabilities from HIV prevention efforts in Lesotho.
In addition to her journalism, Ntsoaki serves as the Country Coordinator for the Regional Media Action Plan Support Network (REMAPSEN). She is also a 2023 CPHIA Journalism Fellow.
