Development of HIV and TB Sustainability Roadmap Part B for the Kingdom of Lesotho

1.      Purpose

On World AIDS Day 2024, His Majesty King Letsie III unveiled Lesotho’s HIV and TB Sustainability Roadmap Part A. This document underscores the government’s dedication to eliminating HIV and TB as public health threats. It also urges all stakeholders to focus on ensuring the sustainability of the HIV and TB response for all Basotho, ensuring no one is left behind.

The Roadmap Part A outlines high-level outcomes and identifies pathways of transformative change to sustain progress in the HIV and TB response beyond 2030. It is organized across six core domains: 1) Governance and Political Leadership, 2) Enabling Policies, 3) Community Services, 4) Sustainable and Equitable Financing, 5) Services and Solutions, and 6) Systems. Roadmap Part A was developed with the leadership of a National HIV and TB Sustainability Working Group (SWG) in an inclusive process that engaged stakeholders across different sectors.

Following the launch of Roadmap Part A, the Government of Lesotho is planning the development of the HIV and TB Sustainability Roadmap Part B (hereafter referred to as ‘Roadmap’). The roadmap will be a dynamic, transformative implementation plan, outlining what is needed to implement the high-level sustainability outcomes identified in Roadmap Part A. The roadmap will include detailed steps and resource requirements for its implementation, including a comprehensive monitoring and evaluation plan, quality improvement and risk mitigation plans. It will guide Lesotho towards achieving its HIV and TB response goals and ensuring long-term sustainability. It will inform the country’s planning for the HIV and TB response, including operationalization of national strategies, ensuring that sustainability is an integral part of these strategies. Beyond the immediate HIV and TB response, implementation of the roadmap will strengthen the overall health system and contribute to improved healthcare delivery, access to integrated health services, and a healthier, more resilient population where all Basotho can thrive.

In February 2025, an Executive Order issued by the United States Government, instituted a 90‑day suspension of most U.S. foreign assistance, including PEPFAR. Despite a subsequent waiver to preserve essential HIV and TB services, PEPFAR operations in Lesotho have not fully resumed, leading to significant service disruptions. The Ministry of Health led a coordinated response—mapping the impact, implementing emergency mitigation measures such as government support for salaries and redeployment of staff, and developing medium‑term strategies to stabilise services. The Roadmap Part B will reflect both these current funding realities and anticipated future changes in the HIV and TB financing landscape in Lesotho—emphasizing a resilient, locally anchored response framework.

The purpose of this consultancy is for a Local Individual Consultant or Local Consultancy Firm (hereafter referred to as ‘Consultant’) to support the Government of Lesotho in developing the HIV and TB Sustainability Roadmap Part B.

2.      Background

Lesotho has made tremendous progress and is at HIV epidemic control. According to UNAIDS Spectrum estimates, 97% of all adults living with HIV knew their status, 94% of all adults with diagnosed HIV infection were on antiretroviral treatment (ART), and 94% of all adults receiving ART achieved viral suppression. These achievements have been driven by strong high-level political commitment towards achieving the country’s goal to end AIDS as a public health threat by 2030, coupled with partnerships with civil society organizations, communities of people living with HIV, and development partners.

Lesotho has also made strides towards sustaining the HIV response, with the government procuring 73% of the country’s antiretrovirals, the remaining 27% contributed through donor funds, and particularly The Global Fund. The Government of Lesotho is leading efforts to further strengthen the country’s HIV and TB response sustainability efforts with the goal of achieving this by 2030. The Government, with leadership of the national Sustainability Working Group, seeks to develop a Roadmap Part B, outlining the transformative strategies and measurable milestones, and ensuring no one is left behind. The roadmap will be a dynamic document, aligned with the high-level outcomes contained in the country’s HIV and TB Sustainability Roadmap Part A, and cognizant of the current and future challenges to sustain the HIV and TB response to the year 2030 and beyond.

3.      Scope of Work

The Consultant will be responsible for the following tasks, utilizing the global sustainability Roadmap Part B guidance from UNAIDS (Technical Guidance – UNAIDS Sustainability Website):

• Facilitate the SWG re-prioritisation of Roadmap Part A
  • Support micro fiscal analysis using the nationally developed tools and UNAIDS RAFT tool and identify resources needed for sustaining the program and possible sources of funding in the absence of main donors
  • In light of funding landscape analysis, support the SWG to re-prioritise the Roadmap Part A milestones utilising modelling
• Facilitate development of a Dynamic Transformational Roadmap Part B in collaboration with technical teams:

1. Develop prioritized, evidence-driven, two and five-year benchmarks
2. Develop the two – three-year transformation plan.
3. With support from SWG and technical teams, develop the two-year Transformation Plan translating commitments and outcomes into
   1. strategies and actions to transition from donor funding, advance policies, programmes, and systems sustainability.
   1. Mechanisms, functions, response components that will transition to fully national ownership.
   1. Integrated financing framework: increasing domestic financing while leveraging/aligning donor investments (e.g. Global Fund, PEPFAR) as a bridge towards self-reliance.
4. Develop a Monitoring and Evaluation Plan:
   1. Facilitate the development of a robust monitoring and evaluation framework that maintains rigor while being low cost, scalable. The framework should break down transformative steps into key milestones, benchmarks, and indicators to track progress and evaluate outcomes, while integrating with national planning and government M&E systems.

• Engage with Stakeholders:
  • Support the SWG facilitation of inclusive and targeted consultations with key stakeholders with guidance from the SWG.
  • Consolidate data and information from various stakeholders and sources for effective engagement of stakeholders and informed Part B development process.

• Develop a Risk Mitigation Plan:
  • Support the SWG to develop a domain-by-domain quality assurance and risk assessment and mitigation plans utilizing the Plan-Do-Study-Action Model 

4.      Deliverables

1. An inception report with a detailed Workplan.
2. A detailed and edited HIV and TB Sustainability Roadmap Part B document aligned to the UNAIDS and SWG guidance.
3. Monitoring and evaluation plan with milestones, benchmarks, and indicators.
4. Quality management plan.
5. Risk mitigation plan.
6. Progress report(s) to SWG.
7. PowerPoint summary of the Roadmap Part B.

5.      Required Qualifications and Experience

• Advanced degree in Public Health, Social Sciences, Economics, Monitoring and Evaluation or a related field.
• At least 10 years of experience in HIV and TB program management, monitoring and evaluation, or sustainability planning.
• Proven experience in facilitating strategic planning processes.
• Proficiency in M&E and demonstrated experience developing monitoring and evaluation plans.
• In-depth understanding of the HIV and TB response in Lesotho, and familiarity with the global HIV and TB response, including current and potential challenges and the funding landscape.
• Fluent in Sesotho and English.
• MS Office proficiency specifically Excel.
• Capable of working independently.

6.      Essential Skills and Competencies

• Excellent Communication, Facilitation and Stakeholder Engagement Skills:
  • Ability to clearly convey information and ideas to diverse stakeholders.
  • Proficiency in facilitating stakeholder consultations, to generate critical reflections, gather diverse inputs and building consensus.
  • Experience in engaging with government, civil society organizations, private sector, communities, and development partners and to ensure active participation.
• Analytical Skills:
  • Demonstrated experience in analysing complex data
• Knowledge of HIV and TB Context:
  • In-depth understanding of the HIV and TB landscape, including current and potential challenges.
• Transformative Thinking:
  • Ability to develop transformative actions, measurable milestones, indicators and an implementable long term sustainability roadmap.
• Adaptability and Flexibility:
  • Ability to adapt to changing circumstances and respond effectively to new information and evolving challenges.
  • Flexibility in implementing the assignment.

7.      Working Arrangements

The Consultant will report to the National SWG Chair leading this assignment.

• The consultant is expected to deliver this assignment with minimal supervision.
• The Consultant will work closely with the Secretariat (National AIDS Commission), that is supporting the implementation of this assignment.
• The Secretariat will provide the Consultant with detailed guidance, required documentation and necessary support to successfully deliver the assignment.

8.      Duration: 35 days

9.      Application Requirements

Interested Consultants should submit their applications in a single email titled “Sustainability Roadmap Part B Consultancy.” The email should be sent to [email protected], with a copy to [email protected], by close of business on 27 August 2025 and include the following attachments:

1. An expression of interest maximum two pages outlining their qualifications and experience and indicating a daily consultancy rate in $US.
2. A technical proposal outlining their approach to this assignment (maximum two pages).
3. A detailed Curriculum vitae of the individual or Lead consultant demonstrating relevant experience, skills and competencies as required in terms of reference.
4. Evidence of similar assignments completed and /or references.

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