“World AIDS Day 2022: How to ensure no one is left behind”

 AMBASSADOR MARIA E BREWER

Today is World AIDS Day, and we have much to celebrate when it comes to the global response to the HIV/AIDS epidemic.  In sub-Saharan Africa, new HIV infections are down by one-third since 2005; AIDS-related deaths have declined by nearly 40 percent; and access to lifesaving HIV treatment has increased by more than forty-fold.

As with the rest of the world, Lesotho’s HIV/AIDS response has also improved markedly.  The results of the 2020 Lesotho Population-based HIV Impact Assessment – LePHIA – which were released earlier this year, showed that Lesotho has exceeded the UNAIDS goal of 90-90-90 – our definition of reaching epidemic control – meaning that 90 percent of individuals with HIV know their status, 90 percent of those who know their status are on treatment, and 90 percent of those on treatment are virally suppressed.

And despite the Covid-19 pandemic, Lesotho has maintained its HIV efforts.  Lesotho has scaled-up the use of HIV self-testing, expanded access to multi-month dispensing, and completed the transition to the TLD treatment regimen as recommended by the World Health Organization.

These are all impressive accomplishments during a difficult time.  But while there has been a lot of progress since the peak of the HIV/AIDS epidemic, we still have more to do.

The UNAIDS theme for this year’s World AIDS Day is, “Let’s equalize.  HIV services for all.  Leave no one behind.”  Globally, the HIV epidemic has become concentrated in several groups, including: the key populations (KP) of sex workers, men who have sex with men, injecting drug users, the transgender population, and prisoners; adolescent girls and young women (AGYW); and children.

While the 2020 LePHIA showed that Lesotho had reached the UNAIDS 90-90-90 goals for 2020, the groups mentioned above have lagged, in large part due to the stigma and discrimination they face when seeking the provision of services.

You may be asking yourself why it is important to focus on these vulnerable groups.  The answer is that only by ensuring these groups receive both treatment and prevention services will Lesotho be able to maintain epidemic control and achieve its future targets: 95-95-95 by 2025 and the end of the HIV epidemic by 2030.

This means the chances that someone passes HIV to you or someone you know are reduced.  It also means that more Basotho can live and thrive with the health and well-being they deserve.  As a result, that the Mountain Kingdom will be more stable and more prosperous.  This won’t be possible unless we ensure no one is left behind.

The United States has been Lesotho’s steadfast partner in responding to the HIV/AIDS epidemic.  The U.S. Government, through the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) is the largest donor to the national HIV response in Lesotho (PEPFAR funded 61 percent of the national HIV response in 2021-2022), while the Global Fund to Fight AIDS, Tuberculosis and Malaria, or the Global Fund (of which the United States is traditionally the largest donor), is the third largest.

Over the past 15 years, the United States Government has provided a total of $817 million, or over M14 billion, in funding to support the national HIV response.

We will continue to work with the Government of the Kingdom of Lesotho and our other partners, including the Global Fund, the UN Family – often represented by UNAIDS – and other non-government and community-based organizations.

To ensure the future targets are met and AIDS is eradicated in Lesotho, it is not only up to these organizations.  Each one of us has a role to play, especially in combating the stigma and discrimination that prevent people from getting tested and staying on treatment.

To that end, I encourage all of us to:

• Ensure you are well informed about HIV (one good resource is https://www.hiv.gov/)
• Be intentional when you choose your words and mindful of how they can affect those around you (a useful guide on how to talk about HIV in a way that is not stigmatizing is available at: https://www.cdc.gov/stophivtogether/hiv-stigma/ways-to-stop.html)
• Speak out against negative behaviors and statements, including those on social media
• Ensure that you and those around you are aware of their risk, know their status, and learn about prevention
• View the personal stories of people who are living healthy with HIV (In 2019, PEPFAR, with the support and presence of Her Majesty Queen ‘Masenate Mohato Seeiso, produced a PEPFAR Champions documentary, which highlights the inspiring stories of some Lesotho citizens living with HIV: https://www.youtube.com/watch?v=3e_L45-AOOI)
• Dedicate some of your time to HIV-related efforts

Again, let me congratulate the Kingdom of Lesotho on the progress that has been made in its response to the HIV/AIDS epidemic.  The United States stands alongside you today and always as your most resolute partner.  Though we have reached epidemic control, the epidemic is not yet over.

I hope each of you will join me in resolving to do our part to reduce stigma against those living with HIV and to encourage those around us to know their status and adhere to treatment if living with HIV.  We can end this pandemic, but only if we all do our part.

Kea leboha.  Khotso, Pula, Nala.