Remarks: Ambassador Mathew Harrington at Lesotho Defence Force Official TB Clinic Handover Ceremony


His Majesty, King Letsie III,
The Right Honorable, the Prime Minister,
The Honorable Minister of Defense and National Security,
The Honorable Minister of Health
Commander of the Lesotho Defense Force,
Distinguished Guests
Ladies and Gentlemen,

I am delighted to be here today for the dedication of the TB Medical Clinic.  I had the pleasure in late January of touring the clinic with General Motsomotso, when it was in the final stages of completion.   I was very impressed with the work that had been done and am so pleased today to be able to officially hand over this facility to the Government of Lesotho.

Today, there are many thanks to go around, many acknowledgments to be made, because so many people have worked very hard to make this important project a reality.   This clinic is the result of a collaborative effort among the Government of the United States; the Ministry of Health; the Lesotho Defense Force; and the architectural and engineering firm, Zias Company. Today I am honored to join all of you to bear witness to the fruits of this collaboration, which is aimed at providing better health care to the members of the Lesotho Defense Force and their families.

As some of you may know, last Friday, March 24, was World Tuberculosis (TB) Day.  That day commemorates Dr. Robert Koch’s discovery, in 1882, of the bacterium which causes tuberculosis (or TB).  At that time, in the 1880’s, one of every seven people who died around the world died of TB.  Dr. Koch’s discovery opened the way for the diagnosis and cure of TB.  But, 130 years later, we still have much work left to do, because TB remains an epidemic in much of the world.

Here in Lesotho, the impact is especially severe because of the high rates of co-infection between patients with TB and those who are HIV-positive.  Indeed, TB is the leading cause of death among HIV-positive individuals.  In Lesotho in 2015, TB was responsible for one in three AIDS-related deaths.  According to a recent report by the World Health Organization, there were an estimated 17,000 TB cases in Lesotho in 2015.  Of those, 12,000, or 70%, were also co-infected with HIV.

The TB and HIV epidemics are inexorably linked, which makes it impossible to combat one without combating the other.  That is why, over the past decade, the United States has been firmly committed to helping Lesotho fight both diseases.

One example of our commitment is the TB Medical Clinic that we are dedicating today. This $1.4 million state-of-the-art facility will help the Lesotho Defense Force provide high quality TB care, treatment, and prevention, and complements our longstanding support to the LDF in the fight against HIV.  At this facility, members of the LDF and their families will receive both inpatient and outpatient TB care.  Previously, TB services were provided at the Thomas Wellness Clinic alongside HIV and other services.  That arrangement was not ideal, because it put patients not infected with TB at increased risk of infection and exposed the clinic staff to a higher risk as well.   This new building is designed to relieve overcrowding in the other outpatient clinics and to provide appropriate space solely for TB inpatient care.

Since 2001, the U.S. Government has worked to fight the spread of HIV in Lesotho. That support began with the U.S. Department of Defense’s HIV Prevention Program.   U.S. assistance continued in 2007 with programming under the President’s Emergency Plan for AIDS Relief (PEPFAR).   Over the last decade, the United States has, under PEPFAR, committed more than $300 million to help Lesotho fight the HIV/AIDS epidemic.   That’s the equivalent of about four billion maloti.

The U.S. government supports a number of HIV/AIDS prevention activities within the Lesotho Defense Force (LDF).  Funding for those activities comes through PEPFAR to the U.S. Department of Defense and is administered by an implementing partner, Population Services International (PSI).  Currently PSI is implementing a four-year program with the LDF to support HIV testing and to provide high quality Volunteer Medical Male Circumcision (VMMC) services, educational materials, condom distribution, and training for the LDF’s HIV counselors. The funding for this program totals a bit more than $2 million.

In addition, the U.S. has committed $5.2 million this year to support activities across the country focused specifically on TB.  Working together with the Government of Lesotho and Global Fund, these TB funds will focus on five specific activities:

  1. Improving the early diagnosis of TB among PLHIV,
  2. Scaling-up TB preventive therapy for all HIV-positive Basotho who don’t have active TB,
  3. Continuing support for integrating TB and HIV services at all PEPFAR supported sites,
  4. Providing services at some border points and expanding the detection of TB cases using a mobile laboratory that focuses on high risk groups (including factory workers, children, miners, and contacts of TB patients), and
  5. Supporting the Ministry of Health with technical assistance related to the review of national plans, guidelines, and policies.

In closing, I want to underscore how proud I am that the United States and the Kingdom of Lesotho have been partners for more than 50 years, and that we have done many important things together over the course of that half-century. The building we dedicate today is a testament to our partnership.  In the fight against HIV/AIDS, we have stood shoulder-to-shoulder with Basotho for many years.   Together, we are making progress, but there is clearly much work left to do, and we will continue to be by your side in this monumentally important struggle.

Khotso, Pula, Nala.