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Lesotho lags behind in HIV and TB targets


Ntsoaki Motaung

The National AIDS Commission (NAC) in collaboration with EGPAF and Civil Society Organizations (CSOs) have developed a Lesotho CSOs Priority Charter that will was discussed on Wednesday and finalized during a stakeholder’s validation meeting on 28th July.

The Priority Charter shall serve as the culmination of CSOs national coordinated efforts to advocate for HIV and TB issues for Children and Adolescents in Lesotho.

The charter will guide the CSOs engagement with government and donors with a view to improve their response towards HIV and TB among adolescents and children in the country.

According to NAC, the efforts to advocate for HIV and AIDS as well as TB in Lesotho have been challenged by a disintegrated approach where each organization has been working in isolation without synergizing efforts to TB/HIV and AIDS response.

Speaking at the meeting, Mosonngoa Motseko on behalf of the Chief Executive NAC indicated that despite Lesotho’s achievement of 90-90-90 targets, the country still lags behind in meeting TB and HIV targets amongst children and adolescents.

She stated that it is estimated that about 13 000 children aged 0 to 14 years and 306 000 adults above 15 years of age are currently living with HIV in Lesotho.

“It is highly crucial to note that TB case incidence is as high as 611 per 100 000 populations, whilst HIV prevalence is also as high as 25.6% according to LePHIA 2017.The Co-infection of TB and HIV continues to pose challenges of adherence to both anti-tubercular medication and antiretroviral therapy (ART). ART coverage amongst adolescents and young people remains low, whilst viral load suppression amongst children is sub-standard,” she said.

“It is now the time to advocate for HIV and AIDS as well as TB in the country more collaboratively. Thus, the CSO’s Priority Charter we are validating today have fostered the strategic partnerships to advocate for national issues related to HIV and AIDS as well as TB with one voice. It is therefore envisaged that through our concerted efforts, we will reach the set National and Global targets, hence attain the epidemic control by the year 2030,” she said.

Motseko said the National HIV and AIDS Strategic Plan 2018/19 – 2022/23 is the guiding document and thus has been designed to accelerate and recalibrate the response to the epidemic. And similarly, the National Tuberculosis Strategic Plan of Lesotho, 2018-2022 also stipulates that TB is primarily driven by the HIV epidemic and that both are the major Public Health Problems. Hence a need to integrate TB into HIV and AIDS response.

“As the Commission, we are delighted that this Charter is synchronised to the National HIV and AIDS Strategic Plan. Among others, it shall help Lesotho to have more targeted interventions through the provision of TB/HIV and AIDS related interventions to Children and Adolescents. Hence there will be efficiency and effectiveness in service delivery to our target populations, thereby closing the gaps discussed above,” she said.

Meanwhile, Dr Llang Maama from the Ministry of Health said “Today we are witnessing one of the milestones in improving TB and HIV response among the most vulnerable population who are children and adolescents; the development of CSOs HIV and TB Priority Charter for children and adolescents will strengthen the continued efforts to address pediatric HIV and childhood TB in Lesotho. I would like to applaud NAC for your coordination role, the CSOs for their commitment to make the charter a reality and to the donor PEPFAR for funding the consultant to make this process a reality.”

“Despite high Prevention of Mother to Child Transmission (PMTCT) coverage globally, the truth is new infections in children still persist especially among adolescents and young mothers. We still have some pregnant mothers with high viral load and this increase chances of passing the virus to their babies. We have children who are born with HIV but have not tested and don’t know their status, and are not on treatment while other children do not have valid viral load results and some of those with results have high viral load with advanced HIV diseases,” she said.

Maama said TB is particularly difficult to diagnose and manage in children since many do not have access to the most effective tests and child friendly treatments. “Often, children with TB are misdiagnosed and treated for other ailments. Although children are more likely to develop active TB disease when exposed to adults with TB, they are rarely offered TB preventive treatment despite the recommendation by the World Health Organization (WHO). This is especially true for children with compromised immune systems due to young age, malnutrition, or HIV infection,” she said.

Maama indicated that, in order to combat the disease in children, World Health Organization (WHO) and its partners have come up with strategy to meet the goal of zero TB deaths among children worldwide. Achieving this goal requires sustained advocacy, greater commitment, mobilization of increased resources and a joint effort by all stakeholders involved in providing health care for children and in TB control.

She said the CSOs Priority Charter is a significant step of CSOs towards improving national HIV and TB response among children and adolescents in the country.

“I am informed that the Charter bringing together various CSOs stakeholders to speak with one voice when advocating for TB and HIV issues for children and adolescents. On behalf of the Ministry of Health, I would like to acknowledge NAC for coordination of CSOs to advocate for TB and HIV for children and adolescents. I appeal to CSOs to sustain this milestone advocacy journey for our future generation to ensure no child is missed with treatment, care and support. Most of CSOs are working in the communities where these children are found. Please help the clinicians to ensure all missed children and adolescents who are there in the community are linked to facilities for treatment, care and support. The Goal of Ending AIDS in 2030 and the goal of Ending TB can never be a reality if we leave some of the population behind,” she said.

Maama stated that, leaders are needed to be in fore front to ensure TB free world and AIDS Free generation. “I therefore pledge my full personal and ministry’s support for the success of CSOs priority charter to improve TB and HIV response among children and adolescents. Making history by Ending TB in children is possible and Ending AIDS by 2030 is also possible as long as we work together with renewed commitment. Let us be those wanted leaders for a TB free world and AIDS free generation,” she said.

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