In 2020, the Ministry of Health in Lesotho released Approach to the Management of Advanced HIV Disease (AHD). This recommends differentiation of services for stable clients in order to reduce clinical visit frequency and enable health facilities to focus resources on those who require more intensive clinical support. It includes section 4.5.3 “Differentiated service delivery for AHD clients”.
On 9 July 2020, the Ministry released Coronavirus Disease – 2019 (COVID-19) Screening, Testing, Clinical Management, and Prevention of COVID-19 Guidelines for Clinicians, including a section pertaining to HIV (page 30). This section details changes to various DSD initiatives including increased uptake of multi-month ART refills (MMD) for stable clients, MMD for TB preventative therapy and supporting telephonic follow-ups among unstable people living with HIV. Further, the guidelines noted that additional community ART delivery models may be introduced by the Ministry. These guidelines compliment the April 2020 memo HIV program services delivery COVID 19 lock down guidance that advocated for health facilities to promote and facilitate community ART groups.
In 2016, the Lesotho Ministry of Health released the National Guidelines on the Use of Antiretroviral Therapy for HIV Prevention and Treatment. Fifth Edition that specify eligibility criteria for three to six month dispensing of ART (3-6MMD). The guidelines further mention decentralization of HIV services through community adherence groups (CAGs) and integration of HIV programmes with TB, maternal and child health and sexual and reproductive health services.