As at March 2005 funding sources for palliative care in Lesotho were minimal. Lesotho is a non-focus country for the President’s Emergency Plan for AIDS Relief (PEPFAR). However t he US government has pledged to provide technical support to the Government of Lesotho in key technical areas across the continuum of HIV related health care. This will range from prevention to treatment and palliative care for adults and children.¹¹

The Global Fund to Fight AIDS, Tuberculosis, and Malaria (GFATM) Round Two HIV/AIDS grant¹² is for $29 million over five years. The aim is to strengthen prevention and control of HIV/AIDS in Lesotho and to reduce HIV prevalence by 15%. The funds, once released are to be distributed through the Ministry of Finance and Development Planning. The World Bank approved $5 million over four years from early 2005 to increase the capacity of the Lesotho government and community based organisations to implement Global Fund activities, including provision of antiretroviral therapies (ART) and the training of 100 HCBC workers per district per year for five years. Palliative care is not mentioned in the GFATM grant.

Limited funding for HCBC comes from charities, small donors, faith based organisations and mission hospitals. A characteristic of HCBC in this country is the willingness of workers to use their own limited resources to assist the ill and needy in their communities. The Rapid Appraisal states:

HCBC workers do not receive any remuneration, payment, incentive or subsidies in cash or kind; instead, they use their own resources to help the families they are working with. This is viewed as a major challenge for the workers as they find it very difficult to “ go to someone’s home that is hungry, sick and has nothing and not give something to help them”. Many instances are cited of giving food from their own gardens or supplies, blankets, transport money for the clinic, soap, etc. In extreme cases, this has caused problems for the workers with their spouses who become upset that “the little they have is being given away.” The workers expressed a strong desire that even if they are not paid for what they do that they are given assistance to find ways of providing for the families they work with. Despite the HCBC workers’ limited resources, they collectively provide HCBC to large numbers of people and use their own very limited resources to care for, feed and support ill people in their communities.¹³