With a prevalence rate of 23.2%, it is essential that HIV & AIDS be at the top of the development agenda, and that every Mosotho knows their status in order to be able to act accordingly. The endorsement of the government from the top level stressed the importance and urgency with which the epidemic needs to be dealt with here in Lesotho.

The UN Development Assistance Framework (UNDAF) recognizes HIV & AIDS as the key strategic area for all UN agencies working in the country. The focus of UNDP in this area will, first and foremost, ensure that all interventions mainstream HIV & AIDS , meaning that all programme activities will integrate the response to HIV & AIDS at all levels, in all institutions and the Country Office will have an exemplary HIV & AIDS workplace policy.

The role of UNDP Lesotho in addressing the impact of HIV and AIDS in the past includes bringing partners and stakeholders together to assist the Government and people of Lesotho in scaling up the national response to the growing HIV & AIDS pandemic. To this end, UNDP put the response to HIV & AIDS at the core of its programme support advocating for, and strengthening a deeper understanding of the pandemic in Lesotho, working with civil society, non-governmental organisations and the private sector; and mobilising the cultural and political leadership to facilitate the necessary action and transformational processes required to develop a national response to address HIV & AIDS.
UNDP's support to the Government of Lesotho on HIV and AIDS.

Areas of support
1. Scaling up the response against HIV & AIDS through support to institutional mechanisms for coordinated and sustainable delivery (2005-2007) - funded by DFID
The overall objective of the Project is to support the scaling up of the national response to HIV&AIDS through strengthened national and district capacity and coordination mechanisms. The Project has provided support to decentralized national mechanisms to help turn the spread of the pandemic around and achieve a greater impact through relevant and targeted government and stakeholder initiatives. The Project makes a deliberate attempt to reach the highest levels of leadership through advocacy and transformational leadership interventions to help re-define the leaders’ role in HIV&AIDS prevention. It encourages new thinking and approaches, calling for an urgent and radical change in the way business is done in the country in relation to the response to HIV&AIDS. The implementation strategy for the programme focused on scaling up the response at three levels: 1) Local level with particular emphasis on the new local government structures, and District AIDS Task Forces under the National AIDS Commission, 2) The National Planning System to strengthen core streaming of HIV and AIDS into the budgetary and planning process, 3) The management of the Public Service to ensure an enhanced institutional performance for scaling up the national response to HIV and AIDS.

The project re-focused its support in 2007, to support the implementation mechanisms of the National ‘Know Your Status’ campaign through the Ministry of Health & Social Welfare.

2. Greater Involvement and empowerment of People Living with AIDS (GIEPA)
With the third highest prevalence of HIV & AIDS in the world of 23.2%, Lesotho has prioritised its national MDGs. Halting and reversing the spread of HIV & AIDS is positioned as the fundamental MDG to be addressed for development to progress towards achieving the MDGs. The current UN Development Assistance Framework (UNDAF 2004-20007) reflects this emphasis, creating HIV & AIDS competent society as the first national priority. The Government of Lesotho has requested the support of the UN to scale up the national response in all spheres and across all levels of society.

Women and girls increased vulnerability due to social, economic, legal and cultural issues combines with biological susceptibility to HIV. Compounded in mobile populations of women who move to urban areas for employment, this translates into a higher risk of infection and greater burden of the disease. The effects are especially pronounced between the ages of 15-24 where the prevalence of young women is nearly triple that in young men (14.3% and 5.6% respectively) , corresponding to intergenerational partnerships with the peak male prevalence at 30-34 years (41.1%). It is then essential that both men and women are empowered to support the rights of all people living with HIV & AIDS to have a meaningful impact on the lives of Basotho.

3. Know Your Status Campaign
On 1 December 2005, World AIDS Day, His Majesty King Letsie III launched the operational plan of the “Know Your Status Campaign” for universal access to VCT. This plan is the product of a multi-sectoral and multi-organisational effort, highlighting the importance of continued collaboration with development partners and government. The plan promotes the need for enhancing an enabling policy environment along with appropriate training and capacity building for effective service delivery.

Using HIV&AIDS as an entry point for effective governance, UNDP is geared to strengthen collaborative efforts to use the HIV & AIDS crisis as an opportunity to strengthen transformational leadership at all levels, with focus on the public service to operate more effectively to deliver services to the poor.

Since HIV & AIDS was declared a National Disaster in 2000 by His Majesty King Letsie III, there have been many developments at the national and local level in Government and with the introduction of international partners. Coupled with the threat of chronic poverty and structural food insecurity, it is clear that the country is now facing development challenges threatening the very existence its people, demanding a total shift from the old ways of planning and doing business to new and radical approaches.

As outlined in the Country Programme Document (CPD) 2005 – 2007, HIV & AIDS continues to be a focus for UNDP and is identified as one of the four areas of concentration including Poverty and Food Security, Environment and Energy, and Democratic Governance.

4. Community Capacity Enhancement programme through Community Conversations (CCE-CC)
The Community Capacity Enhancement (CCE) through Community Conversations (CC) is an approach that encourages and empowers communities to address their own concerns and problems. The methodology can address a variety of development challenges; especially HIV&AIDS related issues such as prevention, care, treatment, reduction of the pandemic’s impact on the livelihoods of a population, as well as Gender issues.
The programme reinforces the communities’ capacities to generate and transfer knowledge through support of community-to-community lessons and experiences. This initiative strengthens already existing HIV & AIDS services (VCT, PMTCT+, ARV) and will effectively complement Lesotho’s extensive progress in social mobilization in demanding delivery of services and strengthen the voice of the increased network of partners in HIV & AIDS in the promotion of the ‘Know Your Status’ campaign. It also gives a local forum to address community perspectives and attitudes towards people living with HIV & AIDS, such as respecting their rights and involving them in processes affecting their lives and communities demonstrated by their active roles as Facilitators in the programme. The goal is a self-perpetuating and sustainable project, because it involves training and the sharing of knowledge.

The overall result will be to enhance the capacity of local communities to tackle problems related to HIV & AIDS that entail prevention, care and treatment and impact mitigation, and increased support of the implementation of the ‘Know Your Status’ campaign.