Strengthening Laboratory Diagnosis and Monitoring to Scale up and Improve HIV/AIDS Care and Treatment Services in the Kingdom of Lesotho under PEPFAR (CDC-Lesotho)


The Kingdom of Lesotho has an HIV prevalence of 23.8, making it the second highest in the world. Despite progress to achieve the UNAIDS 90-90-90 targets, improving quality remains an issue. URC worked to achieve these goals by strengthening the laboratory system to ensure rapid, accurate HIV diagnostic services are available for the entire population. URC focused on diagnostic services, sample transportation, training lab technicians and laboratory capacity building for Lesotho to achieve its UNAIDS 90-90-90 targets.



  • Strengthen capacity of laboratories to expand diagnostic and monitoring services and improve laboratory systems
  • Strengthen and support implementation of laboratory network optimization
  • Strengthen decentralization and improv laboratory capacities
  • Achieve optimal functionality of equipment management system and ensure laboratory instruments are properly maintained
  • Strengthen and support implementation of laboratory continuous quality improvement across the lab network
  • Ensure implementation of WHO-AFRO stepwise process of improving laboratory quality towards accreditation for clinical laboratories
  • Ensure implementation of WHO/CDC stepwise process for improving the quality of rapid testing and point-of-care testing (POCT)
  • Ensure enrollment of testing facilities in proficiency testing program, training, and mentorship of staff, and implementation of biosafety and waste management measures
  • Strengthen laboratory information system (LIS) and monitoring and evaluation (M&E) system
  • Strengthen LIS and M&E system including dashboard, connectivity, eReporting, SMS message system, and monthly/quarterly reporting results



  • Improved national viral load coverage from 51 percent in FY18 to 66 percent by Q2 of FY19
  • Rolled out eReporting and SMS Notification Tool to 208 health centers across all 10 districts of Lesotho
  • Developed and established LIS Dashboard hosted in District Health Information System 2 software
  • Improvement POCT HIV panel proficiency testing participation and performance from 78 percent and 89 percent in FY18 to 98 percent and 98 percent respectively in FY19
  • Provided in-service trainings for 929 healthcare workers comprised of lab technologists, lab mentors, and POCT providers (nurses and counselors)


A young mother with her child in Lesotho. © 2017 Emily Major-Girard/HELP LESOTHO, Courtesy of Photoshare
A young mother with her child in Lesotho. © 2017 Emily Major-Girard/HELP LESOTHO, Courtesy of Photoshare
2015 to 2020
US Centers for Disease Control and Prevention (CDC)
Network of Excellence in People-Centered Testing and Treatment (NEXT)
Riders for Health
Regions/ Countries 
Geographic Scope 
All the 10 districts of Lesotho (Berea, Leribe, Maseru, Mafeteng, Mohale's Hoek, Butha-Buthe, Mokhotlong, Thaba-Tseka, Qacha’s Nek, and Quthing).