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Lesotho moves towards mass treatment of worm infections

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Lesotho moves towards mass treatment of worm infections

By: Michael Mike

To address the severe impact of parasitic worm infections on children’s health, nutrition, and education, the Ministry of Health in Lesotho, in collaboration with the World Health Organization (WHO), has initiated steps to re-establish its Mass Drug Administration (MDA) programme for Soil-Transmitted Helminths (STH).

This is done through the annual administration of albendazole tablets to target both preschool-aged children (1–5 years) and school-aged children (6–15 years). To prepare for the implementation of this critical intervention, a three-and-a-half-day multi-sectoral workshop was held in Leribe District, focusing on the development and validation of a comprehensive operational manual to guide future MDA implementation.

WHO has reported that over 1.5 billion people globally are infected with soil-transmitted helminths (STH), making it one of the most widespread infections. This parasitic disease is particularly prevalent in low-income and tropical regions.

The AFRO region faces the highest burden, with more than 800 million people at risk. Around 290 million school-age children in this region require preventive chemotherapy.

All Saharan African countries are endemic for STH, underscoring the critical need for comprehensive health interventions.

Lesotho conducted its initial national STH mapping survey in 2015, which revealed an overall prevalence of 47.6%, with significant district level variations, some reaching as high as 99%. This led to the launch of an MDA program in 2017, which, however, ceased operations after 2019 due to various challenges,including the COVID-19 pandemic, leaving at-risk populations vulnerable once more. Population at risk in Lesotho is around 550,000.

STH infections are classified by the WHO as Neglected Tropical Diseases (NTDs), characterized by their prevalence in populations with limited access to adequate sanitation and healthcare facilities. These parasitic infections contribute to adverse health outcomes, particularly among children, impacting their nutrition, growth, and educational performance.

A multi-sectoral approach is key to effectively and sustainably controlling and eventually eliminating STH infections in Lesotho and other high-burden areas. It involves not just the health sector (like mass drug administration), but also other sectors that address the main causes of transmission, such as poor sanitation, unsafe water, and poor hygiene.

Dr. Dhruv Pandey, the Technical Expert on Tropical and Vector-Borne Diseases, WHO Multicounty Assignment Team for the Southern Africa Hub countries, emphasized that the discontinuation of MDA since 2019 could have a detrimental impact on both public health and socioeconomic development in Lesotho.

He stressed the need for renewed political and intersectoral commitment, stating:
“It is essential for the Ministry of Health to prioritize the resumption of MDA by initially integrating it within existing health programmes, such as immunization and HPV campaigns.STH is not merely a health issue; it is a social issue, influenced by multiple social determinants and should be addressed through coordinated action.”

Ntsoaki Mamoeketsi Mokete, National Integrated Disease Surveillance and Response (IDSR) Focal Person at the Ministry of Health, highlighted the significance of the newly developed operational manual.

“Developing the operational manual is an important step towards controlling and eliminating neglected tropical diseases in Lesotho,” Mokete said. She outlined future plans, including five years of continuous MDA followed by an impact assessment survey to determine the status of STHs in the country.

“Our next steps will be to continue with the MDA for five years,which will be followed by the impact assessment survey to determine the distribution of schistosomiasis and soil-transmitted helminths (STHs) among the general population. This will enable us to implement effective deworming strategies for the elimination of STH as a public health problem in the Kingdom of Lesotho.
In addition, we will focus on advocacy for the revitalization of school health programmes, developing NTD clinical guidelines, integrating NTDs into the IDSR strategy, and developing a coherent and well-coordinated approach in collaboration with the Ministry of Education and other related organizations.” 

The Ministry of Education and Training (MoET) also affirmed its commitment to the program. Mpheng Molapo, Coordinator of the Learner Care and Welfare Support Unit at MoET, underlined the direct benefits for students.

“The Ministry of Education strongly supports the implementation of the (MDA) for (STH) as a key public health intervention with direct impact on learner well-being, educational performance, and school attendance,” Molapo stated.

Dr. Pabolo Nonyane, District Veterinary Officer and National Focal Point for the Ministry of Agriculture, Food Security and Nutrition, underscored the importance of the MDA to the agricultural sector.

She stated that: “This initiative is vital for achieving sustainable food and nutrition security, particularly within our high-risk agricultural communities. Farmers and herd boys are uniquely vulnerable due to their exposure to contaminated soil. By using this operational manual to protect their health, we preserve the human capital essential for our agricultural future. This effort truly reflects the ‘One Health’ principle, ensuring that our work on STH contributes not only to public health but also directly to Sustainable Development Goal 2: Zero Hunger.”

“The development of Standard Operating Procedures (SOPs) for the MDA campaign against Soil-Transmitted Helminths is essential,” stated Matebele Setefane, UN-Water Global Analysis and Assessment of Sanitation and Drinking-Water (GLAAS) Focal Person, Ministry of Natural Resources.

“This manual provides a structured, standardized approach that ensures clarity of roles and alignment with broader health and Water, Sanitation and Hygiene (WASH) goals. Given that STH infections are strongly linked to inadequate sanitation and poor hygiene, integrating WASH elements into the MDA operational SOPs helps address not just treatment but also prevention.”

Setefane further emphasized the collaborative nature of the initiative: “The success of the MDA campaign depends not only on drug distribution but also on addressing the environmental drivers of STH transmission. Our ministry is committed to supporting the campaign through WASH integration, by collaborating with the Ministry of Health to ensure safe water access, functional sanitation facilities, and hygiene promotion are prioritized in targeted communities and schools.”

The workshop convened a multidisciplinary team, including representatives from the Ministries of Education, Nutrition, Water, Sanitation and Hygiene (WASH), and Environment. This collaborative approach aims to ensure the operational manual is pragmatic and implementable across all levels of engagement, marking a critical step towards establishing a sustainable, multisectoral intervention for STH control and eventual elimination as a public health problem in Lesotho.  

WHO, working with other partners, has been instrumental in operationalizing the implementation of MDA in many countries, providing support at every stage of the process. This includes ensuring the sustainability of high-quality MDA, facilitating annual reporting, and conducting a comprehensive impact assessment after five years of optimal coverage.

Lesotho moves towards mass treatment of worm infections

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Troops Repel ISWAP Attack on Mandaragirau FOB, Detonate IED During Clearance Operation in Borno

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Troops Repel ISWAP Attack on Mandaragirau FOB, Detonate IED During Clearance Operation in Borno

By Zagazola Makama

Troops of the 162 Amphibious Battalion under Operation Hadin Kai have successfully repelled an attack by suspected Boko Haram/ISWAP terrorists on Forward Operating Base (FOB) Mandaragirau in Borno State.

Security sources said the attack occurred at about 2:00 a.m. on August 15, 2026, when the terrorists launched a coordinated assault on the base from two separate fronts.

According to the sources, the troops, who were on high alert, immediately engaged the advancing terrorists after sighting them. The Battalion Commander reportedly led standby troops to reinforce ambush teams already deployed along likely enemy approaches.

A heavy exchange of fire ensued, during which the troops decisively repelled the attack on one axis, inflicting significant disruption on the assailants.

In a separate manoeuvre, another group of terrorists attempted to bypass the ambush positions and breach the camp through the river line. However, they were also successfully repelled by the troops, forcing the attackers to withdraw in disarray.

Following the encounter, troops pursued the fleeing terrorists, but the operation was later halted due to poor visibility and difficult terrain. Security sources said further exploitation of the area would continue at first light.

No casualties were recorded on the side of the troops, while the number of terrorist casualties could not be immediately ascertained. The situation in the general area was described as calm but highly unpredictable.

Meanwhile, troops conducting follow-up clearance operations along the Mandaragirau–Kana axis on the morning of August 15 discovered and safely detonated a command-detonated improvised explosive device (IED) suspected to have been planted in anticipation of troop reinforcement movement.

Security sources said the IED was detected short of a bridge along the route and was safely neutralised by the clearance team before it could be triggered.

In a related development, troops also discovered the corpse of a civilian who had reportedly fallen victim to another IED planted by the terrorists in the area. The remains were found a few metres from the detonation site during the clearance operation.

Authorities said detailed assessment and photographic documentation of the incidents would be provided as troops conclude ongoing clearance operations in the axis.

Troops Repel ISWAP Attack on Mandaragirau FOB, Detonate IED During Clearance Operation in Borno

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ISWAP Fighter Surrenders in Borno After Eight Months in Terrorist Camp

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ISWAP Fighter Surrenders in Borno After Eight Months in Terrorist Camp

By Zagazola Makama

A 25-year-old suspected Islamic State West Africa Province (ISWAP) fighter has surrendered to troops in Monguno Local Government Area of Borno State after spending about eight months with the terrorist group.

The surrendered fighter, identified as Alhaji Ali Gambo Kanuri, a native of Ngarinna village in Monguno LGA, reportedly joined the group about eight months ago after being introduced by a friend.

According to military sources, Gambo later became disillusioned with life within the terrorist group and decided to abandon the organisation.

His decision to surrender was reportedly influenced by the difficult conditions confronting members of the group amid sustained military operations against terrorist enclaves in the North-East.

Gambo eventually made his way out of the terrorist-controlled area and surrendered to troops in Monguno town, where he was taken into custody for further processing.

Military sources said the former fighter was subsequently transferred to the appropriate authorities for further action in line with established procedures for persons who voluntarily disengage from terrorist groups.

His surrender comes amid sustained military pressure against Boko Haram and ISWAP elements operating across Borno State, with security forces continuing clearance and counter-terrorism operations in various parts of the North-East.

Authorities have continued to encourage individuals associated with terrorist groups who are willing to disengage from violence to surrender peacefully and submit themselves to the established screening and rehabilitation processes.

ISWAP Fighter Surrenders in Borno After Eight Months in Terrorist Camp

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Al-Shabaab and the Emerging Debate Over a Taliban-Style Political Transition

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Al-Shabaab and the Emerging Debate Over a Taliban-Style Political Transition

By Zagazola Makama

A growing debate within Al-Shabaab’s media ecosystem over the possibility of negotiations with the Federal Government of Somalia may signal an important internal discussion about the future direction of the militant group.

The debate has gained attention following the publication of two articles by a writer using the alias Eng. Kurtun Hassan, whose writings have appeared extensively in Al-Shabaab-affiliated media.

The articles raise questions about whether Al-Shabaab could eventually pursue a path comparable, in some respects, to the political transition undertaken by the Taliban in Afghanistan, including negotiations and eventual engagement with the international community.

The emerging discourse is significant because it goes beyond battlefield developments and touches on the central question of whether Al-Shabaab could evolve from an insurgent organisation into a political and governing authority.

Sources cited in the emerging reporting suggest that elements within Al-Shabaab’s leadership may be considering negotiations with the Federal Government of Somalia, potentially through foreign intermediaries trusted by both sides.

The reported discussions, however, have not been publicly acknowledged by the Somali government or Al-Shabaab leadership as a formal negotiation process.

According to the assessments, the militant group’s leadership may be waiting for what it considers favourable political and security conditions before making any public decision.

Such a development, if eventually confirmed, would represent a major departure from Al-Shabaab’s longstanding strategy of armed insurgency.

For nearly two decades, the group has sought to challenge the Somali state and establish its own interpretation of Islamic governance, while maintaining links to the broader jihadist movement.

Another important aspect of the emerging debate is the reported interest among some Al-Shabaab members in developments in Afghanistan and Syria.

Sources indicate that senior members and sympathisers are closely following questions surrounding governance, military affairs, state administration, security and economic management in those countries.

In some Al-Shabaab-controlled areas, including Jilib, Bu’aale and Kunyoo Barrow, discussions are reportedly becoming more open about whether the organisation could transform itself into a governing authority.

Some members and sympathisers are said to be comparing Al-Shabaab’s existing administrative structures with armed groups that emerged during the Syrian conflict.

The argument reportedly advanced by some of them is that Al-Shabaab already possesses taxation systems, administrative structures and mechanisms for controlling territory that could potentially be adapted into a broader system of governance.

Al-Shabaab remains one of the most powerful jihadist organisations in Africa. Its manpower is difficult to establish with certainty, but available assessments have placed its overall strength at around 20,000 members, including approximately 12,000 armed combatants.

The organisation has also developed significant revenue-generating mechanisms, including taxation, extortion and illicit economic activities.
Estimates of its annual revenue have exceeded $100 million, although such figures are difficult to independently verify.

At the same time, the group has faced growing financial pressure over the past three years as the Somali government, supported by regional and international partners, has intensified efforts to disrupt its financial networks.

The pressure could be contributing to internal discussions about the sustainability of prolonged armed conflict.

If the reported discussions are eventually confirmed by independent sources, they could represent one of the most significant strategic debates within Al-Shabaab since its emergence as Somalia’s dominant jihadist insurgency.

A transition from armed jihad towards negotiations and political participation would fundamentally alter the security landscape in Somalia and potentially across the wider Horn of Africa.

However, the comparison with the Taliban should be treated cautiously. The Taliban’s eventual return to power was shaped by a unique combination of military, political, diplomatic and regional circumstances. Al-Shabaab operates in a different political and security environment, and there is no guarantee that its internal debate will produce a similar outcome.

More importantly, discussions about negotiations do not necessarily mean that the group has abandoned its jihadist ideology.

Militant organisations have historically used political engagement, negotiations and ceasefires for a variety of strategic purposes, including gaining time, reducing military pressure or improving their bargaining position.

Perhaps the most consequential issue is whether Al-Shabaab is genuinely reconsidering the transnational jihadist ideology that has guided its activities for years. Reports suggesting that elements within the organisation are studying governance models in Afghanistan and Syria may indicate an attempt to rethink the group’s long-term political identity.
But this remains an area requiring substantial corroboration.

There is currently insufficient evidence to conclude that Al-Shabaab as an organisation has formally abandoned its jihadist ideology or decided to enter negotiations with Mogadishu.

The writings attributed to Eng. Kurtun Hassan are therefore important less because they constitute an official policy declaration, and more because they provide a window into a debate that may be taking place within the group’s wider media and ideological environment.

The key question now is whether the debate will remain an intellectual discussion among Al-Shabaab’s members and sympathisers or evolve into an actual political strategy endorsed by the group’s senior leadership.

Several indicators will be important to watch: changes in Al-Shabaab’s public messaging, statements from senior commanders, shifts in its relationship with foreign jihadist organisations, changes in its taxation and governance practices, and any indications of contact with Somali authorities or foreign intermediaries.

For now, the evidence points to an emerging debate rather than a confirmed political transition.

Nevertheless, the fact that questions about negotiations, governance and engagement with the international community are reportedly being discussed within Al-Shabaab’s own media environment deserves close attention.

If the debate eventually moves from discussion to policy, it could mark the beginning of a fundamentally different phase in Somalia’s long-running conflict — one in which the battlefield may increasingly give way to negotiations over power, governance and the future of the Somali state.

Al-Shabaab and the Emerging Debate Over a Taliban-Style Political Transition

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