To effectively fulfil its mandate to co-ordinate the national response under the national strategic plan on AIDS 2006-2011, the National AIDS Commission (NAC) needs to understand the scope and effect of HIV and AIDS interventions in Lesotho. In order do this, a functional and robust M & E system needs to be in place. This document is the implementation plan of the national M & E framework to which all stakeholders have committed to using as part of the ‘three ones' principles

The HIV and AIDS epidemic in Lesotho is of a mature pattern, with a high case-fatality ratio, large numbers of orphans and vulnerable children, increasing mother-to-child transmission, decreasing life expectancy, declining productivity, affecting the national economy and very high demands on the health care system. The prevalence of HIV in Lesotho is estimated at 23.2% of adult Basotho aged 15 to 49 years by 2005, translating to approximately 266, 000 adult men and women living with HIV infection. The prevalence is particularly high in urban areas at levels of 28.8% compared to 21.8% in the rural areas with a considerable variation in prevalence rates by district. The HIV prevalence is highest among the 15 to 49 years age-bracket and skewed towards women with 55% of diagnosed cases of HIV, and more among young women than young men of similar age with a ratio percentage of more than 60% to less than about 30% for young males.