Aid is a quintessential piece of economic development and growth, specifically in places like Africa, a continent with some of the most challenges to furthering economic growth and development. Lesotho is a lower-middle income country with a population of 2.3 million, whose population is calculated to increase 29% by 2050. This is consistent with lower-income countries, where mothers have more children when they do not expect one or more to survive.

The most vulnerable groups in Lesotho are farmers, young girls and children and women. USAID programs in Lesotho such as USAID Global Health Supply Chain Program-Procurement and Supply Management Program (USAID GHSCP-PSMP), which started in 2016, was a program that promotes effective supply chain management for HIV/AIDS medication. Other programs include the DREAM Initiative, which started educating young women and girls about HIV protection in 2016, and Bophelo Bo Botle or Good Health Activity, which began in 2024, and works to educate people on good health practices.

The Ways That Lesotho Benefited From US Foreign Assistance 

USAID programs in Lesotho have helped address the epidemic of HIV/AIDS. For example, the World Health Organization (WHO) reported in 2024 that the country had 1.5 new cases of HIV/AIDS for every 1,000 people in the uninfected population, showing significant progress from 260,000 total cases in 2008. When countries are able to educate their citizens about the harms and prevention methods, or are able to give life-saving treatments, the country is able to put more focus into furthering economic growth. When countries are able to educate their citizens about the harms of HIV/AIDS and prevention methods, as in the case of the Bophelo Bo Botle model and the DREAM Initiative, or are able to give life-saving treatments via the USAID GHSCP-PSMP, the country is able to put more focus into furthering economic growth.

The data from the World Health Organization and UNAIDS shows the epidemic to be on the brink of containment. Further, the life expectancy of the country has improved from 44.3 in 2008 to 57.8 in 2024. However, compared to the world life expectancy, 73.48, Lesotho is lagging behind. This could be due to a number of things, but is mainly due to the extreme poverty plaguing Lesotho, but more broadly, plaguing Sub-Saharan Africa as a whole.

USAID programs in Lesotho have helped significantly with the epidemic of HIV/AIDS in previous years up to 2024 and the United States has funded more than $100 million towards economic growth and development in Lesotho. For example, through the GHSCP-PSMP model, it has has helped promote the proper management of HIV/AIDS medications, leading to an increased amount of sterile needles and medications for HIV treatment. It has also provided $63.4 million towards irrigation planning and infrastructure, and allocated $29.5 million to primary health care services, such as the DREAM Initiative. This could explain the upward trends of life expectancy data.

Specifically, the GHSCP-PSMP model has helped in the proper management of HIV/AIDS medications, leading to an increased amount of sterile needles and medications for HIV treatment. $63.4 million towards irrigation planning and infrastructure and $29.5 million allocated to primary healthcare services, like the DREAM Initiative (Foreign Assistance). This could explain the upward trends of life expectancy data.

Bophelo Bo Botle

The Bophelo Bo Botle Activity started in 2024 in Lesotho. This program focuses on educating people in Lesotho on general good health practices by utilizing people-centered prevention, care and treatment. This program was unfortunately terminated in 2025 due to United States budget cuts and cuts to the PEPFAR program. With the program only running for a year, the program did not have many accomplishments.

The DREAM Initiative

The DREAM Initiative began in Lesotho in 2016, focusing on the factors making adolescent girls and young women vulnerable to HIV/AIDS. Such factors include “gender-based violence, exclusion from economic advancement opportunities and a lack of access to secondary education.” This program, after three and a half years running, saw new infections of adolescent girls and young women decrease by 71.4% in the two districts the program was running in.

USAID GHSCP-PSMP

The USAID Global Health Supply Chain Program-Procurement and Supply Management Program (USAID GHSCP-PSMP) began in 2016, and is scheduled to end in September 2026. This program has promoted supply chain management of HIV/AIDS medication and treatments. The USAID GHSCP-PSMP provided continued availability to HIV treatment and tuberculosis treatment. As of 2020, “97% of HIV positive adults were receiving antiretroviral treatments and 92% were virally suppressed.”

Setbacks

All of this progress comes with a substantial budget cut for USAID programs in Lesotho, and in U.S foreign assistance all around. In 2025, the U.S. gave $24.7 million in total aid to Lesotho. This is a stark difference from just three years prior, when it gave $150 million.

However, the Chinese government has been strengthening relationships with Lesotho, along with 53 other African countries, and implementing many educational and health-based practices through foreign aid. For example in 2024, China and UNAIDS pioneered a joint-campaign called “Eliminating the Triple Threat in Girls and Young Women in Lesotho,” which reached 20,000 young women and promised $2 million USD. This is very promising after the budget cuts the United States made.

China also introduced scholarships for Lesotho in 2025. These scholarships are helping create skilled workers and “ease the financial burden of overseas education.” This is very promising after the budget cuts the United States made.

Looking Forward

Considering the U.S. foreign aid cuts, USAID programs in Lesotho like the DREAM Initiative, GHSC-PSM and the Bophelo Bo Botle Activity may not be able to continue. Thankfully, China has stepped in and introduced new programs and initiatives geared towards economic growth and development in Lesotho.

– Lily K Gibson

Lily is based in Bristol, CT, USA and focuses on Global Health and Politics for The Borgen Project.

Photo: Pexels