Physicians Set Up AIDS Testing, Treatment in Lesotho
Without drastic measures, AIDS could wipe out almost the entire population of Lesotho, a Southern African country of 2.2 million. Nearly one in three adults are estimated to be HIV positive, and 75 percent of HIV positive persons don’t know they are infected.
Jim Yong Kim, MD, PhD, chief of the Division of Social Medicine and Health Inequalities (DSMHI), has worked closely with the government of Lesotho to develop what some have called a radical solution—a universal offer of voluntary counseling and testing for HIV. No country yet has attempted to offer every one of its citizens an HIV test, but the Know Your Status campaign in Lesotho could set the standard worldwide for fighting the disease. Kim and other DSMHI physicians also are involved in a major effort to scale up AIDS treatment in the country’s most remote regions.
“Lesotho carries one of the world’s highest HIV burdens, literally threatening the country’s survival,” Kim said. “The only way to prevent that is through the kind of bold thinking that Know Your Status represents. But beyond the initiative’s importance for Lesotho, this approach could revolutionize how we tackle the AIDS epidemic in the rest of the world.”
Kim collaborated with Lesotho’s minister of health to develop plans for the enormous task of testing the country’s entire population. This campaign is expected to begin officially over the next few months, when health care teams will reach out to each village and test people confidentially in their homes or other health care sites. The campaign also ensures that everyone offered an HIV test will have access to treatment, prevention and care.
Jennifer Furin, MD, PhD, the director of the Lesotho effort for BWH, and other DSMHI physicians are working with Partners In Health and the Clinton Foundation to reach out to the most rural and mountainous areas of the country—places so remote they can only be reached by small plane. The initiative, which will make extensive use of trained community health workers, begins in two health centers during the next few months and will expand from there.
“Lesotho faces significant challenges in its fight against AIDS—high infection rates, extreme poverty and rugged terrain, to name just a few,” Furin said. “But there is great political will and popular resolve to implement testing and get treatment to everyone who needs it. So, there’s also reason for optimism. We want to do everything we can to help Lesotho win this battle.”