America-based funder to Lesotho’s HIV/AIDS programmes has threatened to pull out from one of the country’s implementing bodies over its alleged failure to meet target, the MNN Centre for Investigative Journalism has learnt.
A leaked email that landed before eyes of the Elizabeth Glazer Pediatric AIDS Foundation staff in Lesotho has sent shockwaves and discomfort to the 900-strong workforce when they realised the United States President’s Emergency Plan for AIDS Relief (PEPFAR) had noted an imminent withdrawal from funding the organisation, a fortnight ago.
It is understood PEPFAR is the major funder of the foundation and that if it pulls out, the latter’s staffers face retrenchment.
Also known as EGPAF-Lesotho, the foundation seeks to end pediatric HIV/AIDS through the implementation of preventive, care and treatment measures, as well as through advocacy and research.
It currently supports 175 sites in Lesotho’s ten districts to implement a comprehensive package of HIV and TB services. The foundation advocates at the national level to inform health policies, and conducts research to inform improved HIV/AIDS programming.
But the foundation can only do all these with funding from PEPFAR.
The ‘bad-news’ email had forced the foundation to call an emergency meeting at one of the local hotels on September 17.
“Following the email, an urgent staff meeting was called where we were assured that things weren’t as bad and that we needn’t worry about our jobs, but it was stressed that we have to meet the funder’s targets,” a source spoke to the Centre on condition of anonymity for fear of job loss.
Although the source could not show the email to the Centre, he indicated PEPFAR had noted its concern over the foundation’s failure to realise target and its intention to withdraw its financial support.
“It’s not very settling from what we’ve heard, but we have decided to keep calm about this as per the management’s advice. Indeed, the management didn’t say blandly that funding was at stake but it was embedded in their assurance and plea for us to ensure we increase our capacity,” the source said.
When contacted for official comment the foundation did not deny there was an urgent meeting following the email.
Its Communications and Advocacy Manager ’Makopano Letsatsi was technical in answering questions.
She downplayed the situation, telling the Centre that they organised staff meetings bi-annually “with all districts-based staff to review progress, troubleshoot and address any challenges.”
According to the PEPFAR Country Operational Plan of 2018, which the foundation implements, the involvement of American relief plan in the fight against the pandemic in Lesotho is to contribute to the national HIV response to achieve 95 percent of people living with the virus identified; 95 percent of those identified put on treatment; and 95 percent of those on treatment virally suppressed.
The plan indicates that PEPFAR will focus on finding people living with HIV who don’t know their status, getting them on treatment, and retaining them in care to achieve sustained viral suppression; reduce new HIV infections and improve quality of lives.
Sources privy to the situation indicate that PEPFAR’s benchmarks highlighted the foundation’s failure to keep HIV patients on treatment.
One of the foundation’s employees deployed at a government facility in Maseru told the Centre that EGPAF-Lesotho was unable to trace most of its patients because they changed HIV sites time and again. He said they were unable to be traced them electronically.
“PEPFAR’s concern is that we are failing to ensure that people living with HIV adhere to the treatment. That is true because once their viral load is supressed, most Basotho stop coming for their monthly dose rendering it difficult to trace them,” the source said.
The source stressed that EGPAF was the right hand of the government and “if PEPFAR was to withdraw its funding, we are going to lose our jobs, but what is at stake is everything of antiretroviral treatment. A lot of Basotho who are adherent will be in trouble.”
Another privy source said there was a management meeting earlier before the staff emergency meeting, where the foundation tailored a remedial plan to meet target.
The source said in their defence, EGPAF blamed the Lesotho health system which it said was still ‘analogue’ thus preventing them from effectively tracing patients.
Even this allegation was shot down by Letsatsi who only noted in her email response that the foundation’s technical assistance to the ministry of health helped to strengthen the sector’s systems through human resources, trainings, medical supplies and equipment support, among others.
“EGPAF enjoys a strong, cordial relationship with the ministry of health at national and district levels. EGPAF reviews its performance jointly with the health ministry and together work to address challenges periodically,” she noted.
Melissa Schumi Jones, Public Affairs Officer with the U.S. Embassy Maseru, referred the Centre to the COP 18 (Conference of the People), indicating that Lesotho was one of the 13 countries identified in the PEPFAR Strategy for Accelerating HIV/AIDS Epidemic Control (2017-2020).
In a rounded response to specific questions including whether PEPFAR was indeed planning to withdraw funding, Jones’ response said the U.S. government annual investments was to ensure that “every U.S. dollar is maximally focused and traceable for impact.”
“It is the basis for approval of annual U.S. government bilateral HIV/AIDS funding in most partner countries, including Lesotho. The PEPFAR Country Operational Plan serves as a source for ‘Congressional Notifications’; a tool for allocation and tracking of budget and targets,” she said.
Jones added PEPFAR enjoyed strong partnership with the foundation.