Remarks By PEPFAR Lesotho Coordinator Reuben Haylett at the Launch of the Revised National ART Policy Guidelines: Test and Treat

Delivered at Senkatana Centre of Excellence, Maseru

Khotsong, bo ‘me le bo ‘ntate

Please allow me to pay my respects to:

  • His Majesty King Letsie III;
  • The Honorable Prime Minister; Dr. Pakalitha Mosisili
  • Honorable President of the Senate;
  • Honorable Speaker of the National Assembly;
  • The Honorable Deputy Prime Minister And Leader Of The House;
  • Her Ladyship the Chief Justice;
  • Honorable Ministers;
  • Honorable Minister of Health and your team;
  • Excellencies Heads Of Diplomatic Mission And Heads Of International Organizations:
    • UN Resident Coordinator,
    • WHO Representative,
    • UNAIDS Representative
  • Principal Secretaries;
  • Distinguished Guests, Ladies And Gentlemen;

All protocols observed,

Good morning,

It is my great honor and pleasure to be here today representing Ambassador Matthew Harrington who is unable to join us as he is traveling outside of Maseru.   Ambassador Harrington had very much wished to be here and asked me to expressely communicate his heartfelt congratulations on this important decision to move forward with Test and Treat.   

In December 2014, just a few short months after his arrival, Ambassador Harrington made his first World AIDS Day speech in Lesotho.  In that inspiring speech, he looked back on how far we had come and drew a simple map for us all towards an AIDS-free generation. What he said has resonated throughout our efforts in Lesotho ever since – Treatment Works!

Today Lesotho is taking another important step forward and ensuring that all HIV positive Basotho are able to access life-saving treatment as soon as they are diagnosed, regardless of their CD4 count.  The revised ‘National Guidelines for HIV and AIDS Treatment adopts the 2015 WHO guidance recommending immediate ART for all people diagnosed with HIV, Pre-Exposure Prophylaxis to be available for highly vulnerable sub-populations and streamlined ART service delivery models for stable patients. With today’s launch Lesotho is once again demonstrating the dynamic leadership and courage that is needed to achieve and AIDS-free generation.

I would like to congratulate the Government of Lesotho, headed by His Majesty King Letsie III, the Honorable Prime Minister, and the Minister of Health and his team, for adopting the WHO Test and Treat guidelines for all people living with HIV so promptly.

The unmet need for treatment is still high.  Today, globally, only 15.8 million out of the 37 million people who are living with HIV are 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.  That is why the United States Governement, through the President’s Emergency Plan for AIDS Relief (PEPFAR), is supporting countries to adopt the WHO guidelines.  The evidence shows that starting HIV treatment early is a crucial tool to controling 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.

The 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.

The successful implementation of Test and Treat is critical to realizing the revised National Strategic Plan 2020 goals ensuring that,

  • 90% of all people living with HIV will know their HIV status,
  • 90% of all people living with HIV who know their status will be on ART, and
  • 90% of people on ART will be virally suppressed.

Last year the PEPFAR program in Lesotho reported over 36,000 HIV positive people identified but just over 27,000 newly enrolled on treatment.  Test and Treat, with the option for immediate initiation on ART, will help the HIV program strengthen the linkage between diagnosis and treatment.  The revised guidelines also enable Lesotho to prescribe Pre-Exposure Prophylaxis for populations at a high risk of acquiring HIV and use of HIV self-testing kits to reduce barriers to people knowing their status. These are additional tools in the arsenal that will allow clinicians to increasingly tailor the HIV services to fit the clients’ needs.

The United States government is committed to working with the Ministry of Health and other stakeholders to support the WHO-recommended treatment guidelines and effectively implement them in Lesotho.  With the generous support of the American people, the United States government through PEPFAR has committed more than $52 billion worldwide and over $265 million to the bilateral HIV response in Lesotho.  PEPFAR Lesotho is already planning for a further $51 million next year that includes $11.8 million of support for the rollout of the new guidelines including Test and Treat.

As we all know the true cost of this epidemic is measured in lives saved.  When you consider the 39 million lives that have been lost globally to this epidemic since it began, and the millions more we may loose in the future, the question really becomes how can countries afford NOT to take all necessary steps to end AIDS, once and for all.  In the longterm, lives saved also means dollars saved.  By getting all people living with HIV on treatment now and keeping them on treatment, the health benefits and cost savings will greatly outweigh the cost of Treatment for All.  As stakeholders in the HIV/AIDS response, we must urgently intensify our efforts and resolve to ensure that all Basotho Get Tested Now, Get Treated Now, and Live Longer!!!!!!

Thank you.