The Lesotho government has announced the closure of the Health Maintenance Project Implementing Unit (HM-PIU), which is responsible for maintaining 226 clinics and hospitals across the country. The unit's shutdown on September 30, 2026, has raised concerns about the potential risks to the health of over 1.3 million Basotho, more than half of the nation's population. The HM-PIU plays a crucial role in ensuring that health facilities remain functional by providing essential services such as water supply, power, sewerage, and medical waste management.
The closure of HM-PIU also threatens the jobs of approximately 5000 people employed by 111 contractors that service health facilities, as well as around 70 posts within the unit itself. Sources close to the development have warned that the dismantling of the unit without clear transitional arrangements could disrupt essential maintenance services from October 1, 2026. This could lead to delays or interruptions in the provision of essential maintenance services, potentially compromising patient care.
According to a letter from the Ministry of Health's Acting Principal Secretary, Matšoanelo Monyobi, dated September 1, 2026, the unit's responsibilities and functions will be taken over by relevant departments within the ministry. However, sources have questioned the practicality of this transition, citing a lack of clear direction on how HM-PIU's functions, resources, systems, and ongoing activities will be transferred. This has raised concerns about the ministry's ability to maintain health infrastructure to the required standard.
The HM-PIU was established in 2023 within the Ministry of Health, taking over maintenance responsibilities and systems previously managed by the Lesotho Millennium Development Agency (LMDA). The unit oversees 226 health facilities countrywide, providing hard facilities maintenance, environmental and healthcare waste management, ICT-related support, and other facilities management services. Its closure has raised concerns about the potential impact on the continuity and sustainability of health facility maintenance services.
The Lesotho Millennium Development Agency (LMDA) operated from around 2015 to 2023, managing and maintaining a portfolio of health facilities and other infrastructure built under the Millennium Challenge Compact (MCC). The MCC, implemented through the Millennium Challenge Account-Lesotho (MCA-L), financed the construction, rehabilitation, and upgrading of health centers across Lesotho. The closure of HM-PIU has raised concerns about the government's ability to maintain infrastructure built under this investment to an acceptable standard.
The Christian Health Association of Lesotho (CHAL), Maseru City Council, and Lesotho Red Cross health facilities are among the beneficiaries of maintenance support now facing possible disruption. Sources have argued that the situation poses a substantial risk to the continuity and sustainability of health facility maintenance services. Without urgent action, clear direction, and coordinated participation from the ministry, essential maintenance functions may not be adequately sustained after September 30, 2026.
The Ministry of Health has promised to communicate further instructions regarding the transition through appropriate channels. However, the Lesotho Times was unable to obtain comment from Ms. Monyobi on the concerns raised by sources. The government's ability to maintain health infrastructure to the required standard remains a pressing concern, particularly given the condition precedent set by the United States requiring the Lesotho government to maintain infrastructure built under its Compact I investment to an acceptable standard.
Key points
- The closure of HM-PIU poses significant risks to the health of over 1.3 million Basotho.
- The unit's shutdown could disrupt essential maintenance services, potentially compromising patient care.
- The government's ability to maintain health infrastructure to the required standard remains a pressing concern.
