2 May 2025 by Limpho Sello

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“We are too often left out of both the data and the dialogue.”

Refuoehape Sesinyi’s firm, reflective voice cuts through the silence that too often surrounds the experiences of persons with disabilities in the HIV response.

Sesinyi, a visually impaired activist, represented the Lesotho National Federation of Organisations of the Disabled (LNFOD) at a multistakeholder meeting convened to gather Lesotho’s input for the upcoming Global AIDS Strategy for 2026–2031.

Held on April 28, 2025, at the United Nations House in Maseru, the meeting followed the impending conclusion of the current Global AIDS Strategy in 2025. There, Sesinyi spoke on behalf of hundreds of people with disabilities across Lesotho. 

“If the new global strategy includes persons with disabilities as a key priority, then that vision will trickle down regionally and nationally,” Sesinyi said. 

She made reference to a gender gap analysis conducted by LNFOD. The analysis revealed high rates of gender based violence (GBV) against people with disabilities, most of it unreported and widespread barriers to accessing sexual and reproductive health (SRH) services.

“Many of us do not even know how or where to get services, especially in rural areas. And when we do know, the services are not accessible. This needs to change,” she stressed.

Financing gap

At the meeting organised by the Joint United Nations Programme on HIV and AIDS (UNAIDS), country director Pepukai Chikukwa noted that the global response to HIV has made significant progress with countries like Lesotho nearly reaching the 95-95-95 targets. 

Chikukwa indicated that this significant progress further includes reducing new HIV infections by almost 75 percent since 2010. However, the inequalities remain deeply entrenched, noted Chikukwa. 

She said the new strategy must address these gaps by ensuring inclusivity across all populations, particularly among children, adolescents, and young women. 

She also acknowledged the challenges ahead, especially amid shifting development and funding policies, but remained hopeful. 

“Where there is a crisis, there is also opportunity. We must be ambitious, innovative, and efficient in the next phase of the HIV response,” Chikukwa said. 

At the same event, Lebohang Mothae, Chief Executive  of the National AIDS Commission (NAC) localised the strategy and spoke more about the importance of domestic financing and a strong political will to see impact in the HIV response. Mothae emphasised the urgent need for sustainable and equitable HIV financing within Lesotho. 

“Despite government investment in health, we still heavily rely on external support. Worse, there’s a financing gap even with that support,” she warned.

She stressed that Lesotho must own and strengthen its systems, including financial accountability and policy enforcement. 

“Strong political leadership is essential. Without it, we cannot sustain or scale our response. Communities must remain at the heart of this strategy from villages to constituencies,” Mothae explained.

Building on the call for inclusive leadership and community-driven solutions, Sesinyi poignantly noted, “If we are not visible in the data, in the clinics, and in the strategy, then we are still being left behind.”

Her call for disability-inclusive SRH services echoed a broader plea for community-led, locally relevant solutions.

Meanwhile, Mothae highlighted the importance of legal and policy environments that promote human rights and gender equality. 

“We need to eliminate stigma and discrimination, especially against marginalised groups. Our response cannot be effective if it is not inclusive.”

Lesotho to prioritise its HIV response

Maema Ramaema, NAC’s Strategic Information Manager, called for a complete reevaluation of how Lesotho prioritises its HIV response. 

“We may need to drop some activities that are no longer effective and shift focus to high-impact solutions. This means rethinking community engagement, rechanneling government funding, and renegotiating strategies,” Ramaema explained.

He stressed the importance of sub-national health facility strengthening and regional production of health commodities.  

“The goal is not just to maintain treatment, but to provide comfort and consistent care for people living with HIV and their families. Sustainability demands more than good intentions; it demands practical, political, and financial shifts.”