The Lesotho apparel industry is the country’s largest private sector employer, employing around 46 000 workers, mainly relatively unskilled women - about 85% of the workforce are women. Surveys within the secor show that 43% of employees are HIV-positivs.

For a number of years regional development agency ComMark Trust, in partnership with the Lesotho National Development Corporation, has been providing technical assistance to the apparel industry in Lesotho. In 2005 ComMark received funding from the UK’s Department for International Development (DFID) to design a strategy to address HIV and AIDS in the industry. ALAFA, the Apparel Lesotho Alliance to Fight Aids, was born in the course of that process.

Alafa means "to care for the sick" in Sesotho, the language spoken in Lesotho.

You can download a copy of the feasibility study and proposed intervention model - A Private Sector Response to HIV and AIDS in Lesotho

Supporting ALAFA

ALAFA, as its name implies, is an alliance. The project is hosted by the Lesotho Textile Exporters’ Association, with government, industrialists, labour, brands and retailers,  funders, donors and multinational organisations working together to combat the pandemic.

The project is managed by a core staff of 10 full-time people and two part-time staff, based in Maseru, under the control of a management committee and an advisory council. Services are provided by a range of both non-government and private sector providers. Funding is assured through the brands (EDUN, Wal-Mart, Gap Inc., Levi Strauss, Nordstrom), bilateral donors (DFID & Irish Aid) and multilateral donors (European Commission). Workers on treatment also pay a small amount for treatment and the factory owners are setting up and staffing factory clinics. Lesotho's ministry of health and social welfare is supplying the private doctors with antiretroviral drugs at no cost and also helps in other ways such as seconding counsellors to the factory clinics.

ALAFA uses a mix of different models, but the emerging best practice is an integrated approach with primary health clinics in or near the factory, and contractual arrangements with private doctors and nurses teaming up with factory-based peer educators, counsellors and expert patients. The latter are workers on the programme who have been recruited to help other workers adhere to their treatment. ALAFA has employed two expert patients.

CARE AND TREATMENT

There are three elements to the treatment campaign: voluntary testing and counselling (VCT), registering with ALAFA and presenting at a doctor's or factory clinic for assessment, and regular health monitoring and treatment, which includes ARV treatment when it becomes necessary. 

Factories that want to participate must meet accreditation criteria and commit in-kind and management contributions, including training and clinic facilities, equipment for universal precautions, time-off for training, counselling and treatment. Eighteen factories now have an HIV policy in place or are developing a policy.

An AIDS co-ordinator is appointed in each factory on the programme.

PREVENTION

Prevention lies at the core of any successful intervention, and ALAFA is introducing both comprehensive prevention and treatment programmes that will be rolled out to the entire garment sector workforce, their spouses and dependents. Experience shows that people are more receptive to messages that come from their peers rather than from experts giving talks, and ALAFA uses peer educators as a central part of its prevention strategy. Workers in the factories volunteer and the chosen ones are trained by ALAFA-contracted service providers, who are also trained. The aim is one peer educator for every 100 workers. At present 32 000 workers (66 percent of the workforce) have access to prevention services, and 330 peer educators have been trained.

ALAFA has developed Lesotho-specific peer education material and peer educators receive training based on these materials coaching and mentoring to maintain a common standard throughout the industry

Both male and female comdoms are being distributed to free to the workers.

Another aspect of the prevention component is prevention of mother-to-child transmission (PMTCT) for workers who fall pregnant. More than 70 babies have been born on this programme and all have been HIV negative, except three.

PROJECT GOVERNANCE

Project Advisory Council: The council includes industrial associations, labour unions, brands and retailers, donors, multinational organisations and representatives of the three relevant government ministers and the National AIDS Commission.

Members approve budgets and policies, report on the project to stakeholders, and guide the project director and team.

The PAC meets at least twice a year. The council is being chaired in the first year by the former Lesotho Minister of Trade and Industry, Mr. Mpho Malie.

Project Management Committee: This committee is tasked with the hiring of project staff and the constant monitoring of the project staff's activities .

The committee is made up of two Lesotho Textile Exporters’ Association members, the acting project manager of ALAFA and a member of the ComMark Trust

Financial management

Moores Rowland-Lesotho has been appointed as the project auditors.