Plague outbreak in Madagascar – 2017. WHO trained more than 4400 people to work as ‘contact tracers’ to help prevent plague from spreading further in hard-hit areas. © WHO
The Kingdom of Lesotho
The Kingdom of Lesotho, a landlocked country in the mountains of Southern Africa, is grappling with overlapping public health threats and climate vulnerabilities. Although small, Lesotho is facing outsized risks due to erratic weather patterns, food insecurity and disease outbreaks – exacerbated by its dependence on climate-sensitive agriculture and limited access to health services. More than 70% of the population relies on rain-fed farming, and climate shocks are increasingly translating into health shocks.
Ranked among the 50 countries most vulnerable to infectious diseases and considered at moderate risk of debt distress (IMF, 2024), Lesotho’s capacity to prepare for and respond to health emergencies remains constrained. These challenges underline the urgency of investment in emergency preparedness and response (EPR) systems.
ALLOCATION
US$ 2.1 M
PARTNERS
Food and Agriculture Organization (FAO)
NATIONAL STEERING COMMITTEE
Co chaired by Permanent Secretary, Ministry of Health, Ms. Moliehi Maneo Ntene and WHO Country Representative Dr Innocent Nuwagira. First convened on 23 March 2025
Climate-related health challenges
Lesotho is already experiencing the health consequences of climate change, including rising malnutrition, increased disease outbreaks, and challenges linked to changing rainfall and temperature patterns. The country is recently experiencing extreme temperatures of more than 38°C in summer and below -8°C in winter. Drought has intensified food insecurity, particularly in rural areas, increasing the prevalence of severe acute malnutrition (SAM). Meanwhile, cross-border movement and porous borders with South Africa elevate the risk of transboundary disease transmission.
To tackle these challenges, Lesotho will integrate health considerations into national climate planning, including support to develop a Health National Adaptation Plan (H-NAP), and conduct a health vulnerability and adaptation assessment. The country will also explore health-centred responses to food insecurity, using frameworks such as the Integrated Food Security Phase Classification (IPC) to include health parameters in crisis monitoring.
Early warning and disease surveillance systems
Lesotho will strengthen its surveillance and data-sharing systems through a One Health lens by:
- Conducting a National Bridging Workshop to map cross-sectoral roles and responsibilities.
- Establishing an environmental surveillance system for public health threats, including climate-driven hazards.
- Reviewing and building capacity for IDSR tools and case-based reporting.
- Integrating data across human, animal and environmental health sectors via the national Public Health Emergency Operations Centre (PHEOC).
- Launching a digital platform and surveillance website to improve data-sharing and stakeholder coordination.
- Strengthening sentinel surveillance systems for influenza-like illness (ILI) and severe acute respiratory infection (SARI).
- Expanding mortality surveillance and implementing advanced data analytics tools.
- Procuring essential ICT tools – laptops, tablets and modems – for One Health surveillance officers across the country.
- Supporting regional collaboration and peer learning through study tours to Centres of Excellence.
Laboratory systems
To enhance diagnostics and One Health pathogen detection, Lesotho will:
- Build laboratory capacity to test environmental samples (soil, freshwater, wastewater) for climate-sensitive pathogens.
- Procure advanced equipment, including metagenomics sequencing kits and food safety diagnostic systems.
- Conduct a 10-day national training in metagenomics and support short-term placements for six laboratory technologists at regional laboratories.
- Develop biosafety and biosecurity policy and guidelines across human, animal and environmental sectors.
- Map existing laboratory networks and establish inter-sectoral referral systems, including partnerships with the private sector.
Strengthening human resources and public health workforce
To reinforce frontline health and EPR capacity, Lesotho will:
- Train five cohorts of health workers through Field Epidemiology Training Programmes (FETP), with a focus on cross-border communities.
- Develop and implement a multisectoral workforce and SURGE strategy, grounded in situational analysis.
- Train district Rapid Response Teams (RRTs) and simulate outbreak response using the AVoHC-SURGE framework and 7-1-7 approach.
- Strengthen capacity at points of entry (POEs) by training 69 border health staff in infection prevention and control.
- Conduct HR data analytics workshops and compile a One Health workforce inventory to inform future planning.
- Provide digital tools and training to national and subnational EPR actors to improve outbreak detection and response coordination.
Other goals
Lesotho’s broader objectives include:
- Establishing a Public Health Institute through legislative and policy development.
- Operationalizing the national Public Health Emergency Operations Centre and developing a mentorship programme for EPR leadership.
- Creating a gender-balanced, multidisciplinary Health Emergency Leaders Network.
- Enhancing project visibility, documentation of best practices, and stakeholder ownership.
- Supporting resource mobilization efforts to ensure sustainability beyond the project lifecycle.
- Enhance implementation of IHR monitoring and evaluation framework through second round of Joint External Evaluation which will inform the development of the second national action plan for health security.
Partnerships & implementation
WHO will collaborate closely with the country’s Ministries of Health and Education, alongside the Food and Agriculture Organization (FAO) and the International Organization for Migration (IOM) to support implementation. A steering committee has been established to provide oversight and monitor progress.