Challenges in implementing anti-AIDS policy

The Lesotho government has drafted an impressive anti-AIDS policy, but the country's lack of a "sound revenue base" and inadequate capacity could render it meaningless, a new report has found. Lesotho, a small mountain kingdom surrounded by South Africa, is in the grip of an HIV/AIDS emergency. An estimated three out of every 10 people are infected with the virus, including 60 percent of the country's workforce. In the last six years, the average life expectancy has plunged from 60 years to 39 years. But, in a country with no meaningful national economy, responding to the epidemic would be a "formidable challenge" for Lesotho's policymakers, said a paper by the Institute of Security Studies (ISS). According to the report, "Looking at Lesotho's economy alone ... one might conclude that the country lacks the capacity to implement its HIV/AIDS prevention policy." A huge informal sector juxtaposed with a small commercial sector means a large section of Lesotho's economically active population contribute little revenue to the government. The state's main sources of income are customs unions and aid from developed countries. "Foreign aid and the proper use of it will be critical resources in the country's anti-AIDS campaign" the report commented. Nevertheless, the social and political environment should make the implementation of the AIDS policy easier: high adult literacy rates and widespread access to radios would ensure better information dissemination; a healthcare system with a countrywide network of health service centres offering laboratory, pharmacy and social welfare services was already in place. The challenge would be to speed up the recruitment of technical staff and expand testing facilities, the report added. However, the policy itself was "fraught with some inadequacies". Political parties and traditional chiefs had been excluded, despite their influence over the Basotho. The plan also failed to address the needs of HIV-positive people and did not include the provision of antiretroviral drugs. Although implementing the policy would be difficult, "Lesotho will respond to the challenges of its HIV/AIDS crisis if foreign aid pledges are fulfilled, and if the project is fully managed," the report concluded. More details: www.iss.org.za