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Feature Story
Impact of US funding cuts on HIV programmes in Lesotho
17 March 2025
17 March 2025 17 March 2025Current StatusUSAID Projects: Two projects funded by the US Government have received full activation...
Current Status
- USAID Projects: Two projects funded by the US Government have received full activation notices; one focused on orphans and vulnerable children (in all 10 districts) and DREAMS (in 4 districts) and another focused-on treatment and care in 2 districts.
- CDC Projects: All CDC projects have received full activation notices.
- Other USAID Implementing Partners: Projects focused on key populations (KPs), voluntary medical male circumcision (VMMC), pre-exposure prophylaxis (PrEP), and a large project on treatment and care and health systems strengthening (HSS) are still terminated.
- Overall: Approximately 28% of PEPFAR support has resumed, 32% is still paused and 40% is terminated.
- Of the 1,508 human resources for health supported through PEPFAR funding, 804 (53.3%) are currently terminated
Immediate Risks and Disruptions
- Frequent Changes in Project Status: The frequent changes in the status of US Government-funded projects have caused delays in the activation process.
- Termination Notices: Some USAID implementing partners have received termination notices, causing disruptions in services.
Government Actions
- Task Team: Led by the Ministry of Health and operational since January 27, the task team is mapping out affected US-funded projects and identifying mitigation measures, including government payment of salaries for essential staff, task shifting, recalling staff on leave, and integration of health workers' roles. The immediate priorities of the Ministry of Health and National AIDS Commission are to ensure commodity security, to lead and coordinate through convening task team meetings and expediting development of Part B of the HIV and TB Sustainability Roadmap
- Funding Decisions: Ministry of Health submitted a contingency budget to the Ministry of Finance and Development Planning to cover salaries at government salary scale for critical staff for three months. For the medium term, government and partners are waiting until the end of the US Government review period (April 20) to make significant funding allocation decisions.
Civil Society Response
- Joint Press Statement: Civil society partners, supported by UNAIDS, issued a statement calling for government support and acceleration of social contracting.
- Impact on Civil Society: Some CSOs are receiving activation notices, while others, like LENEPHWA (network of people living with HIV), remain under termination.
UN Response
- UNAIDS is collaborating with the Government to plan mitigation measures for service continuity, supporting civil society advocacy, and maintaining communication with PEPFAR, USAID, CDC, and USAID prime partners.
- UNAIDS is working with the National AIDS Commission and Ministry of Health to expediate development of HIV and TB Sustainability Roadmap Part B, with preparatory and analytical work while awaiting the global guidance.
- Regular Updates: UNAIDS has kept the Resident Coordinator (RC) and UN Country Team (UNCT) regularly updated, with the RC advocating for the establishment of an inter-ministerial task team to monitor the US Government funding situation.
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