Introduction

Howdy. My name is Daniel Evans, and I recently moved to Maseru, Lesotho. Lesotho, for those of you unfamiliar with The Mountain Kingdom (as I was myself prior to taking this assignment) is a small, mountainous country completely surrounded by South Africa. Lesotho is ethnically homogenous, the name of the country itself translating as “the land of the people who speak Sesotho.” With only 2.3 million people Lesotho is a very small country, the vast majority of that population living in rural villages. Lesotho has a very substantial HIV/AIDS problem, with an estimated adult infection rate of ~25%. In 2004 the government began a rigorous program to address both the spread of HIV and to provide free universal anti-retroviral treatment. The scale-up of the program has encountered a number of obstacles, but currently in excess of 22,000 people are receiving treatment and the number continues to grow.

I arrived here a week and a half ago to work as a Procurement Technical Advisor for the Clinton Foundation’s HIV/AIDS Initiative (CHAI). The CHAI team works with international donors and local governments to provide a variety of services, the most noticeable being supplying and facilitating the effective distribution of pediatric anti-retrovirals (ARVs) and other drugs designed to prevent mother to child HIV transmission. In terms of my specific job, I’ll be handling the procurement of pediatric ARVs for the country and then working as a technical advisor with the national Ministry of Health, Global Fund country team, and other aid groups to ensure that appropriate quantities of adult ARVs get into the country and to the hospitals and clinics that need them.

While this blog is meant to cover my time in Africa and most of that will be spent working, I do not envision talking about the specifics of my job that much. There are a few reasons for this. First, procurement is not exactly sexy. No commercial soliciting donations will ever feature me in a windowless office working on a spreadsheet. I meet with vendors, I review invoices, I create forecasts in Excel and argue with various stakeholders about quantification assumptions. Essential work, but not lending itself to interesting narrative (at least to someone of my modest talents). If you have a specific question about something such as the merits of making a contract DDP versus making it DDU with appropriate coverage amendments in the tender terms, I’d be more than happy to correspond with you personally, but I am not going to put everyone else through that. Secondly, there is a fair amount of sensitivity associated with the work and a misconstrued comment or an accidental admission could have serious reverberations. I am working with a lot of people who care very deeply about what they do and have in many cases devoted their lives to helping others. Differences of opinion and outright disagreements are inevitable in situations where you are making tough decisions involving trade-offs with profound human consequences, let alone when you have people working together from very different cultural and work backgrounds. To ensure that clashes or fuel for such does not flow from anything written here, I will largely steer clear of work-related entries. For similar reasons, do not expect to see any pointed criticisms of Lesotho in this blog. The country has its share of issues, as does every country (though it has been pointed out to me locally that at least Lesotho does not export its problems to other parts of the world). What excites me about working here are the number of people I have already met who are excited about improving the situation.