Boasting one of the highest adult literacy rates in Africa, the Kingdom of Lesotho is a small country bordered entirely by South Africa. The population of about 2.2 million resides in an area of about 30,000 square kilometers. Most people live in the western half of the country, and around a few major urban areas, such as Maseru, the capital, home to 202,000 residents. The overwhelming majority of the population consider themselves ethnically Sotho, and speak Sesotho, English, Zulu, and Xhosa. The country is predominantly Christian, with most people identifying as Protestant, Roman Catholic, and other denominations. About two-thirds of Lesotho consists of mountains, with its lowest point 1,400 meters above sea level. Tall mountain ranges form a natural barrier with South Africa. Lesotho is also the source of two of South Africa’s largest rivers: the Tugela River and the Orange River. With no other shared borders, Lesotho must depend heavily on a good relationship with South Africa.

Since gaining independence from Britain in 1966, Lesotho has been transformed and modernized, yet not without some initial growing pains. A number of rebellions, military coups, and contentious elections have plagued the country. Lesotho has also struggled with high levels of poverty: More than half the population lives below the poverty line. There are few natural resources, and the country is susceptible to food insecurity and shortages. Many people cross the border to work in South Africa, as opportunities are lacking in Lesotho. Remittances account for 17 percent of the country’s GDP, highlighting the scope of the problem. Despite these challenges, Lesotho has made great progress in the area of education and is on track to achieve universal primary education.

Lesotho has the second highest HIV/AIDS rate in the world—25 percent of the adult population is HIV positive—and it is the leading cause of death in the country. Other causes of death include tuberculosis, lower respiratory infections, stroke, diarrheal diseases, ischemic heart disease, diabetes, neonatal disorders, road injuries, interpersonal violence, and COPD. The risk factors that contribute most to deaths and disabilities include unsafe sex, malnutrition, air pollution, alcohol and tobacco use, high fasting plasma glucose, high body-mass index, high blood pressure, intimate partner violence, and insufficient water, sanitation, and hygiene. In addition, rates of maternal and infant mortality have remained high over the past decade.