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Lesotho's campaign will use the same models employed by immunisation

programmes: extensive community mobilisation and education followed by door-to-door visits.

The campaign will proceed district by district as treatment and prevention becomes available throughout the country with the aid of a Global Fund grant. A recent WHO analysis estimated that 56,000 people were already in need of treatment by the end of 2004, that the country had between 290,000 and 360,000 people living with HIV, and that treatment might be available for 28,000 people by the end of 2005. However, the Lesotho Ministry of Health admitted yesterday that treatment is currently available for only 6,500 people.

Donna Higgins of WHO's HIV department told aidsmap: "A group of community leaders in each district or village will be trained to recognise when their community is ready for treatment and testing. They will decide how the offer of testing is implemented in their community - for example, they may pick house by house visits carried out by health care workers from outside the community, in order to preserve confidentiality, or they may pick promotion of existing testing and counselling services."

The campaign will begin in Maseru, the capital, and other localities where treatment is already available.

The testing campaign is not intended to present HIV antibody testing as compulsory, and a separate group of individuals in each locality will be trained to monitor the progress of the programme and report any breaches of confidentiality or violations of human rights, Donna Higgins said.

In a mass mobilisation of health care workers, Lesotho will train 6,500 community health workers in voluntary counselling and testing, and a further 6,500 in prevention counselling and adherence support.

Praising Lesotho and other high-burden countries in Africa for finding ways to tackle the issue of HIV/AIDS head on, Dr Jim Yong Kim, Director of the HIV/AIDS Department of WHO, cites the growing availability of affordable AIDS treatment in developing countries in gradually transforming the fight against AIDS.

"Lesotho's initiative is an excellent example of this global trend towards expanding and integrating prevention and treatment efforts," said Dr Kim.

"The growing availability of affordable AIDS treatment in developing countries is gradually transforming the fight against AIDS. Many nations, like Lesotho, are now empowered to develop exciting, bold programmes that directly confront the epidemic. The impact on prevention will be tangible as more communities break the silence surrounding the disease and begin to speak openly about the impact of HIV/AIDS on their lives."

Other high-burden countries in the region are also significantly scaling up HIV/AIDS services. In 2004, Botswana began offering HIV counselling and testing for all people entering health facilities, resulting in significant increases in the number of people aware of their HIV status and accessing other services. Neighbouring Swaziland, with the world's highest HIV prevalence, now provides more than half of its citizens in need with antiretroviral treatment. In addition, Swaziland plans to provide an essential package of HIV/AIDS prevention, treatment and care services in 80% of all health facilities, including the primary health care level, nationwide by the end of 2007. Those who cannot access facilities will be provided with community-based services by the end of 2008.