PEPFAR-Lesotho Coordinator Reuben delivered at the World TB Day 2016

Delivered at Maseru Central Correctional Facility, Maseru

Let me pay my respects to,

  • His Majesty King Letsie III;
  • The Right Honorable the Prime Minister; Dr. Pakalitha Mosisili
  • The Honorable Deputy Prime Minister;
  • Honorable Ministers of Cabinet; in particular the Minister of Health Dr. Molotsi Monyane
  • Distinguished Guests, Ladies, and Gentlemen;

TB is the leading cause of death among individuals living with HIV/AIDS – accounting for one in three AIDS-related deaths in 2015.  Despite making significant progress with ART initiation of the ‘notified’ TB/HIV co-infected patients in Lesotho, less than half of the estimated 12,000 TB and HIV co-infected patients are diagnosed every year.  Mortality for TB remains alarmingly high at approximately 15% and a drug TB resistant prevalence estimate of 3.8% is worrisome.

The Government of Lesotho with partners have the power to change the current TB situation in Lesotho.

  • This year, Lesotho has made a critical step by adopting the 2015 WHO guidelines recommending starting ART for all people diagnosed with HIV. ART is the most powerful prevention tool we have available for HIV-associated TB.
  • Earlier ART will directly impact the TB epidemic by reducing the number of people living with HIV who become sick or die from TB, and reduce TB transmission. Through this approach, we can potentially eliminate 75 percent of TB cases among people living with HIV/AIDS.
  • TB and HIV co-infection remains a priority focus for the U.S. government, and continued emphasis is placed on this dual burden through the U.S. President’s Emergency Plan for AIDS Relief  funding and efforts of U.G. Agencies and their Implementing Partners.

Every year, the USG in Lesotho allocates an average of three million US dollars to address TB and TB/HIV related activities. This funding compliments the central work of the Ministry of Health, and other donors such as The Global Fund for AIDS, Malaria and TB. These efforts will continue to be supported in COP 16.

Our priorities for the coming year include:

  • The USG will continue to support the integration of TB/HIV care and treatment services in the five scale-up PEPFAR districts.  Supporting clinical staff to strengthen and improve the quality of services within TB clinics using the one stop approach. This is aimed at achieving effective TB control to contribute to the country’s 90-90-90 targets through universal HIV testing services in TB clinics.
    • More timely identification of all PLHIV with TB through improved case detection will help to reach the second 90% faster and early initiation on ART for TB/HIV co-infected reduces mortality, morbidity and HIV transmission.
  • The USG will continue to support the scale-up of TB diagnosis using Gene Xpert machines to improve the early diagnosis of TB among HIV-infected. This will close the gap between current estimated TB incidence and current notification rates.
  • The USG will continue to support improvement of TB-case detection among high risk or vulnerable populations using innovative strategies to find people with TB quickly, avert deaths, stop TB from spreading, and halt the development of drug-resistant strains.
  • The USG will support interventions to improve retention on ART and TB treatment as well as support the scale-up of Intermittent Preventative Treatment (IPT) in PEPFAR supported districts not currently implementing IPT.

Let me be clear, together we need to double the current case detection rate for TB identification and scale-up ART to reduce the incidence of TB amongst people living with HIV.  Unless the HIV epidemic is addressed, TB will remain a major burden upon all Basotho.

Let me close by thanking the Honourable Minister Monyamane, his whole team at the Ministry of Health, be they in clinics or hospitals, and finally the National TB Control Program for the work they do daily in this battle.

We look forward to continuing to work in partnership — to support your efforts to change the lives of Basotho for the better.

Khotso, Pula, Nala