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Lesotho scores a first in HIV fight


. . . launches ‘Test and Treat’ strategy for medication regardless of health status

Limpho Sello

LESOTHO on Thursday became the first African country to launch the “Test and Treat” strategy aimed at ensuring that every person who tests positive for HIV is given immediate treatment.

The strategy is part of the 2015 World Health Organisation (WHO) Consolidated HIV Treatment guidelines recommending that everyone tested HIV positive should receive immediate treatment regardless of their CD4 count.

Prime Minster Dr Pakalitha Mosisili, who officiated at the launch at Senkatana Centre of Excellence in Maseru, said the programme represented a departure from previous WHO guidelines. According to the guidelines, HIV-people could only access treatment when their CD4 count was 500 cells and below or when they were very sick as per WHO clinical staging and for selected populations such as pregnant women children.

“With the dissemination of the WHO Early Release Guidelines in September 2015, the world now agrees that antiretroviral therapy (ART) should be initiated in everyone living with HIV at any CD4 cell count,” Dr Mosisili said.

“This recommendation was made on the strength of research studies done all over the world. These studies demonstrated that earlier use of ART has proven to be more beneficial and life-saving than delayed treatment.

He said the “Test and Treat” approach is an evidence-based tool to increase treatment coverage, improve life expectancy and health outcomes for all people living with HIV.

“Lesotho will not only move with the rest of the world, but will lead the way as we become the first country in Africa to implement the ‘Test and Treat’ strategy for the benefit of all Basotho,” said the premier.

Dr Mosisili also bemoaned Lesotho’s status as the country with the second highest HIV prevalence rate in the world, saying the new programme should act as a catalyst to re-energise the country’s efforts to combat the deadly pandemic.

“It is a sad reality that Lesotho has now been catapulted into the unenviable position of being the second country with the highest HIV infection rate in the world,” the premier ruefully noted.

“This reality therefore should spur us into renewed vigour to adopt urgent pragmatic programmes to reverse this status. I stand here today to make a firm commitment, on behalf of the government that we shall do all in our power and with the support of our partners to ensure that the ‘Test and Treat’ guidelines we launch today are implemented.”

He said it was the government also aimed to attain the 90/90/90 treatment target in which 90 percent of all people living with HIV would know their HIV status, 90 percent of all people diagnosed with HIV would receive sustained antiretroviral therapy and 90 percent of all people receiving antiretroviral therapy would have viral suppression.

“This is a 90/90/90 declaration to reduce HIV infection and AIDS death by the year 2020 and this is a commitment behind which we stand firm and resolute and declare we shall achieve,” said Dr Mosisili.

The premier also said the Senkatana Centre was chosen for the launch to build on its success as the first public facility to provide HIV services since 2004.

“From today, everybody living with HIV will be initiated on treatment at Senkatana while the Ministry of Health will work with various development partners  to ensure that as of 1 June 2016, all health facilities provide ‘Test and Treat’ to all those who are HIV positive irrespective of their CD4 count,” he said.

The government, Dr Mosisili said, was concerned that despite interventions and strategic plans implemented through the various services provided by the Ministry of Health, the health system continued to suffer the severe strain brought on by the HIV epidemic.

“The grim reality that Lesotho has the second highest HIV prevalence rate globally, with HIV/TB co-infection rate of 75 percent has resulted in increasing AIDS-related deaths and new infections,” he said.

“ART therapy coverage remains a serious challenge with only 45 percent of eligible adults and 35 percent of eligible children accessing ART therapy.”

The launch was also attended by Reuben Haylett, the coordinator for the United States-based President’s Emergency Plan for AIDS Relief (PEPFAR), an organisation that supports countries to adopt WHO guidelines for fighting HIV/AIDS.

Mr Haylett, who represented US Ambassador Mathew Harrington at the launch, said there was still a long way to go to combat the pandemic as, globally, only 15.8 million out of 37 million people living with HIV were on treatment.

“This means that when it comes to getting everyone living with HIV on treatment, the global community isn’t even halfway toward our goal,” he said.

“That is why the US government, through the PEPFAR, is supporting countries to adopt the WHO guidelines. The evidence shows that starting HIV treatment early is a crucial tool to controlling the HIV epidemic.

“It helps improve the health of people living with HIV, reduces the chances of HIV-related deaths, and also greatly reduces the risk of infecting others,” Mr Haylett said.

“Evidence tells us we can do the right things, the right way, right now.  Individuals benefit because those who need this life saving treatment no longer have to wait until they are very ill before they qualify for treatment.  Lesotho benefits because healthier and more productive Basotho contribute far more to the economy than it costs to keep them on ART.”

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