1,500 Lesotho Health Workers Sent Home After US Aid Suspended

In Maseru, Lesotho’s capital, the government is scrambling to deal with the fallout of US President Donald Trump’s suspension of funds for vital health prgrammes.

• About 1,500 health workers, including doctors and nurses, have been directly impacted by the suspension of US-funded health programmes in Lesotho, affecting HIV/AIDS treatment, TB prevention, and maternal health services.
• Lesotho, which has one of the world’s highest HIV prevalence rates, faces potential reversal of years of health progress, with 240,000 people currently on antiretroviral treatment.
• The government is scrambling to mitigate the crisis with a task force to cover salaries and exploring long-term solutions such as introducing health insurance.

About 1,500 health workers, including doctors, nurses, laboratory technicians and counsellors – working in Lesotho in US funded programmes, have been directly affected by US President Donald Trump’s unilateral suspension of USAID and PEPFAR (the United States President’s Emergency Plan for AIDS Relief), the Lesotho health ministry has confirmed.

Minister of Health Selibe Mochoboroane says the government is working to mitigate the crisis. A task force led by the finance ministry is to secure R27-million to cover salaries for the health workers who have been sent home.

According to the health ministry, the US supports the following programmes in Lesotho: TB treatment and prevention, HIV/AIDS, and all other services related to these diseases like counselling, prevention of mother to child infections and HIV testing. USAID-funded programmes also provide critical maternal health services.

As a temporary solution, the ministry has instructed all district health offices to recall workers on leave and invited final year health students and graduates to volunteer at health centres.

Mochoboroane said USAID Lesotho requested a waiver for essential services such as HIV/AIDS and TB treatment, laboratory tests and counselling.

“The USAID office in Maseru reported to us that they had a meeting, and they are adding addendums to contracts of the affected workers so that they resume their duties,” Mochoboroane said.

“This is a wake-up call for us to be on our own,” he said.

Lesotho must be prepared to make up the M1.2-billion (R1.2-billion).

The government has proposed a long-term plan to introduce health insurance to stabilise funding for health services.

USAID suspension

On 29 January, Prime Minister Sam Matekane acknowledged the longstanding partnership between the United States and Lesotho, emphasising the critical role US aid has played in sectors like health, agriculture and security.

But Trump’s recently signed executive orders suspending financial assistance for 90 days has affected numerous programmes and life-saving health initiatives.

PEPFAR has been one of the largest contributors to Lesotho’s fight against HIV/AIDS. The country has one of the highest HIV prevalence rates in the world, with about 240,000 Basotho currently on antiretroviral treatment. HIV and TB are leading first and second causes of death in Lesotho, according to the Elizabeth Glaser Pediatric AIDS Foundation.

While the government has assured citizens that these treatments will continue, since Lesotho funds 83% of its ARVs and the Global Fund 17% – the broader impact of the cuts on testing, prevention and counselling services is a major concern.

Closing down

While USAID staff in Lesotho continue reporting to work, a source says US officials were given until Monday to leave, while foreign staff have been given a 30-day period to leave. Local Basotho employees remain in limbo, with no clear communication about their future.

USAID and PEPFAR-funded organization include Elizabeth Glaser Pediatric AIDS Foundation, Population Services International, Baylor College of Medicine Children’s Foundation, Jhpiego Lesotho, and many others in Lesotho. All have been left scrambling.

“Most of our employees are home. Only a skeleton staff remains to close out projects. This is the same situation for similar organizations funded by the US,” an employee at one organisation told GroundUp.

Some organisations have suspended operations for two weeks, others for three weeks, said another source.

Moeketsi Chefa, spokesperson at the US Embassy in Maseru, said, “Please note that it might not be easy to get you answers today as we are currently getting guidance from Washington on responding to media inquiries.”

Another casualty of the US funding freeze is the Millennium Challenge Account Lesotho II. On 1 February, Limpho Maema, acting CEO, issued an urgent general notification of work stoppage under the Health and Horticulture Compact, a project valued at US$300-million.

Launched on 11 April last year, the initiative was designed to expand access to quality healthcare, promote equitable business opportunities, and invest in high-value crop production in Lesotho.

Despite the government’s reassurances, questions remain about how Lesotho will cope if PEPFAR funding is permanently withdrawn.

Studies have shown that PEPFAR’s investment has significantly improved Lesotho’s health indicators, reducing new HIV infections and increasing access to treatment. The loss of this funding could reverse years of progress and jeopardize the health of thousands.

Lesotho’s leaders now face the challenge of developing a self-sustaining health system while dealing with the immediate fallout of the abrupt funding suspensions.

Meanwhile, health workers and patients across the country remain in a state of uncertainty, hoping that a resolution will come before the system reaches a breaking point.

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