Lesotho Overview

The mountain Kingdom of Lesotho is a small country, completely surrounded by its much larger neighbour South Africa. Lesotho has the third highest HIV prevalence rate in the world (23.2% of 15-49-year olds are infected) and as a result, life expectancy has dropped from 58.6 to 44.9 years between 1990 and 2008. Many of Lesotho’s 2 million inhabitants depend on small scale agriculture for a living. Because less than 10% of the land mass is suitable for farming, Lesotho produces less than 30% of its total food requirement, resulting in a reliance on imported foodstuffs, and vulnerability to price fluctuations (the regional price of maize tripled between the beginning of 2005 and the end of 2007). Lesotho is the most remittance-dependent country in Africa and the third most remittance dependent in the world, despite continuing loss of employment opportunities in the mining industry in South Africa. 43.4% of the population are classified as ‘very poor’ without sufficient income to meet even their basic needs. 68% of the population live below the local poverty line of €0.41 per day .

Irish Aid’s programme in Lesotho aims to achieve the following results:
• Reduce new HIV rates, provide more widespread antiretroviral treatment and better care for those already         living with HIV and AIDS
• More children in schools, more children completing primary and secondary school
• Better health care for all
• More people having clean water to drink

How does Irish Aid contribute to achieving these results?
Lesotho is often praised for its democracy; its government nevertheless struggles to provide basic services such as health care, education, water and sanitation. Irish Aid supports each of these sectors to improve service delivery. Irish Aid also supports the improvement of financial management within the government. Irish Aid supports the development of better HIV and AIDS workplace policies throughout government departments, acknowledging that to ‘treat, train and retrain’ staff members who are infected with the HIV virus is the best way forward. In addition, Irish Aid is actively engaged in coordinating with other donor countries and UN agencies that support Lesotho, to achieve better development results.

In order to achieve these results Irish Aid provides its support in the following ways:

Health
Lack of well educated staff who can manage, maintain and provide adequate health services are a serious problem. High rates of HIV infection and the ‘brain drain’ that has seen many educated Lesothians seek higher paid employment in South Africa, have robbed the health service of its employees: In 2007 only 2 health centres countrywide employed the minimum staff required. Irish Aid works closely with the Lesotho Ministry of Health and other international development partners to strengthen its response to the HIV and AIDS crisis, and to tackle the problems in the health system.

Irish Aid is involved in updating the national HIV and AIDS strategy, advocates for ‘prevention of mother to child HIV transmission’- drugs to become a routine component of sexual and reproductive health care provision, and for the integration of HIV and TB services.

Irish Aid continues to work through its Irish Aid-Clinton Foundation-Ministry of Health partnership to strengthen the health sector’s response to HIV and AIDS.  The focus of this partnership, since it began in 2006, has been to fund the establishment of nine mountain clinics in the Lesotho Flying Doctor Service sites in order to bring a comprehensive package of HIV and AIDS related services to remote and vulnerable communities. Through the partnership, Irish Aid has provided funding for human resources in health, in particular the temporary reinforcement of 150 additional nursing staff in mountain clinics. A clinical mentorship programme (providing on the job training), and the use of so-called ‘expert patients’ (patients who receive HIV services are trained to assist health centre staff in delivering HIV-related services to other patients) are also part of this initiative, which has enabled over 2,500 patients in these rural areas to start anti-retroviral treatment.

Education
Ireland has been the leading donor in the education sector in Lesotho for over 30 years.
Lesotho is nearly 80% of the way towards achieving the Millennium Development Goal of providing Universal Primary Education by 2015. Much has been achieved in Lesotho following the introduction of Free Primary Education in 2000 but serious challenges remain. Repetition rates and drop out rates are on the increase (20% and 18% respectively), mainly attributed to a lack of qualified teachers in schools, and the impact of HIV and AIDS where children (especially young girls) drop out to take care of sick parents or assume responsibility of earning income in the case of the death of parents. Irish Aid has recently supported the Ministry of Education by providing funds for extra staff, books and HIV and AIDS awareness training to both teachers and pupils.

Irish Aid works closely with other partners (such as UNICEF and UNESCO) in supporting the Ministry of Education to carry out a review of its existing life-skills curriculum. The education sector provides an obvious window of opportunity to teach young people about HIV and AIDS prevention. A new life-skills curriculum has been developed and is currently being tried out in 100 schools. Irish Aid also engages with a number of faith based organisations, teachers unions and other grassroots groups to strengthen their response to HIV and AIDS. Faith based organisations have a critical influence on how church-owned schools accept and teach the new curriculum. Teachers’ unions have been very effective in other countries in working with teachers to change their behaviour in response to HIV and AIDS, and to help them maximise their role in teaching their students about HIV and AIDS prevention. 

Water
Irish Aid is shifting its support for clean water provision from individual projects scattered throughout the country to a more broad country-wide approach by supporting the ministry responsible for water provision. Irish Aid works closely with other donors to develop a programme of support for the water sector throughout Lesotho. Irish Aid funds the mapping out of how many people within the Ministry of Water and Sanitation will need further training, and in which cases people with new or different skills need to be employed, and will provide funding for some of these needs.

Governance
Irish Aid has in the past provided funding to the Office of the Ombudsman, which managed to raise the public profile and effectiveness of that office. Subsequently, Irish Aid lobbied other development partners to move towards a more coordinated approach to support such oversight agencies. This has led to the setting up of a pooled fund, which allows the Independent Electoral Commission, the Office of the Ombudsman, and The Human Rights Unit (established within the Ministry of Justice) to carry out their oversight role of Government more effectively.

Civil Society
Irish Aid is developing partnerships with a number of local community groups in order to strengthen their capacity to monitor government performance in the social sectors (comparing government plans and promises with the actual delivery of services and infrastructure) and influence policy debates. Irish Aid provides them with support to form networks which would further strengthen their ability for influencing local and national government decisions in favour of the poor and those who can least speak out for themselves.