If successful, a programme to combat the spread of HIV/Aids in Lesotho may act as the benchmark for tackling the disease in Africa.
The King of the African state of Lesotho has given his personal backing to a groundbreaking and potentially controversial plan backed by the World Health Organisation (WHO) to introduce universal HIV testing for the entire adult population of the kingdom.
His majesty King Letsie III launched the world's first plan to offer voluntary HIV testing and counselling to every single person by the end of 2007 at an official ceremony outside the capital Maseru on Thursday, to mark World Aids Day.
With a population of just 2.2 million, Lesotho has one of the highest HIV infection rates in the world, with a prevalence of 27 per cent when most recently measured by the government among antenatal clinic attendees.
The country's new campaign will use the same models employed by immunisation programmes across the globe: extensive community mobilisation and education followed by door-to-door visits.
Communities will decide how and when their members will be offered HIV testing and counselling, with independent watchdogs in the form of "people's committees" established at local, district and national levels.
The committee members will be responsible for ensuring that testing is always voluntary, that confidentiality is maintained and that post-test services, including treatment, are provided.
The testing campaign has been devised in an effort to dramatically increase access to HIV treatment and prevention, as a commitment to offer an HIV test to everybody would also have to see a commitment to offer the full range of treatment and prevention to those individuals.
With its population, Lesotho would expect to have an estimated 630,000 people living with the HIV virus, of which 56,000 would be in need of antiretroviral (ARV) treatment.
At present, it is estimated that just 7,000 people are on ARVs. It has been estimated that AVRs can extend the life of a person with HIV in the developed world by 15 years. Similar data does not exist on outcomes in the developing world, but experts believe there is no reason why this type of life extension could not be accomplished in countries like Lesotho.
Speaking at the event, Dr Jim Young Kim, director of the HIV/Aids Department of the WHO, said that this was the most wonderful World Aids Day of his life as Lesotho had the potential to be the first African nation to bring the epidemic under control.
"If you do that you will be a light and inspiration for all of Africa and the world," he told the thousands present.
However, the new campaign may prove controversial both internationally and at a local level. While officially supported by both the WHO and the Lesotho government, the scheme will be the first in the world to apply universal testing and, although such testing will be voluntary, the traditional right not to be tested will be compromised.
Speaking at a briefing in Maseru on the eve of World Aids Day, Dr Kim dismissed this issue and claimed that the success of ARVs had necessitated a complete rethink in terms of human rights surrounding HIV/Aids.
"The human rights issues prior to treatment with triple therapy [ ARVS]was to protect people's right not to know; to protect people's right not to be stigmatised; to protect people's rights not to be killed at times for being HIV positive.
That was the critical issue.
"But now with such a commitment to providing treatment here in Africa we have to ensure people's right to live. And that is the most fundamental human right: the right to live, the right to have children, and the right to raise those children," said the WHO director.
A further potential difficulty on the ground will be the age at which testing will start, set at just 12 years. Speaking after the official ceremony on Thursday, Lesotho's acting prime minister, Lesao Lehohla, indicated that while certain groups, particularly the church, may not perhaps agree with the age threshold chosen, the country was in a "crisis situation" and needed to act.
The event also saw the opening of the first medical centre in Lesotho dedicated to caring for HIV/Aids-infected infants and children, operated by the Baylor College of Medicine in Texas, in partnership with the government and funded by Bristol-Myers Squibb's Secure The Future initiative.
The pharmaceutical company's philanthropic arm has committed $150 million in various schemes to fight HIV/Aids in Africa. It has already set up the largest single treatment facility for HIV-infected children in the world in Botswana, and similar centres are coming on stream in Swaziland, Burkina Faso and Uganda.
The BMS Foundation also intends to establish comparable clinics in China and eastern Europe.