In June 2006, DGHE and Partners In Health began work in Lesotho, a small African nation facing the third highest rate of HIV/AIDS in the world. Almost one-third of Lesotho’s two million adults are estimated to be HIV-positive. As the epidemic has taken hold, average life expectancy has plummeted to 35 years.

The HIV epidemic in Lesotho is driven by poverty and exacerbated by rugged terrain. Outside of the capital city of Maseru, most of the population lives in remote mountain villages hours from the nearest medical outpost. It is in these isolated villages, many of which are accessible only by single-engine propeller airplane or on horseback, that DGHE and PIH have started working to scale up testing and treatment of HIV/AIDS.

The effort in Lesotho was launched under the leadership of DGHE Associate Physician and Hatch Scholar Dr. Jennifer Furin. Within eight months, more than 1,300 patients had been tested for HIV. Nearly 600 patients were diagnosed and treated for HIV and tuberculosis, and 170 HIV/AIDS patients started on antiretroviral therapy.

By 2007, the project had expanded to four clinics throughout the country. In addition to scaling up HIV care, the Lesotho project includes initiatives to improve primary care and care for high numbers of patients with tuberculosis, advance women’s health, provide screening and treatment of sexually transmitted infections and supply nutritional support for those at risk for malnutrition.

The Lesotho project was launched following an invitation from the government of Lesotho. DGHE and PIH are working closely with the William J. Clinton Foundation’s HIV/AIDS Initiative (CHAI), which has been a partner of DGHE and PIH in Rwanda since 2005.

With funding from Open Society Institute (OSI) and in partnership with the Ministry of Health, in 2007 DGHE & PIH launched Lesotho’s first-ever treatment program for multidrug-resistant tuberculosis (MDR-TB), recognizing the extremely high rates of HIV/TB coinfection in the country, and the growing MDR-TB problem. With the recent outbreaks of extensively drug-resistant TB (XDR-TB) in Southern Africa, DGHE & PIH’s expertise in drug-resistant TB (and in dealing with HIV/TB coinfection) was a perfect fit in neighboring Lesotho.