Lesotho is currently working towards achieving the Millennium Development Goals. To achieve the targets for the reduction of child mortality, which forms MDG 4, Lesotho’s target is to reduce under-five deaths per 1,000 live births to 29, and increase measles immunisation to 100 per cent by 2015. In 2012 under-five mortality stood at 100 deaths per 1,000 live births, and measles immunisation at 85 per cent. This data suggests Lesotho is unlikely to achieve MDG 4 by 2015. The global MDG 5 target for maternal health is to reduce the number of women who die in pregnancy and childbirth by threequarters between 1990 and 2015. When applying this target to Lesotho, maternal mortality should fall to 130 cases per 100,000 live births. In the period 2007-11 Lesotho had a reported maternal mortality ratio of 1,200 deaths per 100,000 live births (this figure was estimated at 620 deaths per 100,000 by UN agencies/World Bank in 2010). Based on the data reported by the country, the achievement of this target is unlikely. Part of the goal also stipulates that 100 per cent of births must be attended by a skilled health professional. In the period 2007-12 this figure stood at 62 per cent, so progress towards this target is also off track.
MDG 6 aims for a reduction in the prevalence of HIV, malaria and other communicable diseases. Lesotho’s prevalence of HIV was 23.1 per cent in 2012 (in the 15-49 age group). This figure is extremely high and there has been no significant reduction in HIV prevalence since the advent of the disease in the 1980s. The country also has a high incidence of tuberculosis (TB), which is estimated to have increased significantly in the period 1990-2012, although estimated mortality (when mortality data excludes cases co-morbid with HIV) from TB has fallen slightly during this time.
Accordingly, dramatic progress in these areas is required if the country is to come close to achieving MDG 6.
In 2012, a US government health team utilised a Global Health Initiative (GHI) strategy – a public-private partnership – to promote health care services in Lesotho. The strategy covered issues relating to mother-to-child HIV transmission; orphans and vulnerable children; management and leadership; construction to improve service delivery; and access to integrated services. The Ministry of Health and Social Welfare was provided with assistance in addressing issues with supply chain management in co-ordination with the Global Fund to Fight AIDS, Tuberculosis and Malaria. GHI is specifically focusing on HIV transmission, testing and counselling as well as the overall facilitation of access for at-risk populations.
This effort supports the expansion of the national HIV care and treatment programme, including cases co-existing with TB, throughout Lesotho. It is hoped that the work undertaken under this partnership will also strengthen the capacity for the government and civil society to work together to address the country’s growing number of orphans and vulnerable children.
