Lesotho's major health problems, such as pellagra and kwashiorkor, stem from poor nutrition and inadequate hygiene. As of 2000, 44% of children under five years of age were considered malnourished. Famines have resulted from periodic droughts. In 2000, 91% of the population had access to safe drinking water and 92% had adequate sanitation.
Tuberculosis and venereal diseases are also serious problems. There were an estimated 542 cases of tuberculosis per 100,000 people in 1999. In 1994, children up to one year old were vaccinated at the following rates: tuberculosis, 55%; diphtheria, pertussis, and tetanus, 58%; polio, 66%; and measles, 82%. In 1999 rates for DPT and measles were, respectively, 85% and 77%. About 43% of children suffered from goiter in 1996.
The government of Lesotho is working to rehabilitate two hospitals and is making an overall effort to strengthen health care services. In 1990, there were 74 doctors, 60 pharmacists, and 874 nurses. In the same year, there were 1.4 hospital beds per 1,000 inhabitants. As of 1999, there were an estimated 0.1 physicians per 1,000 people. Approximately 80% of the population had access to health care services in 1995.
As of 2002, the crude birth rate and overall mortality rate were estimated at, respectively, 30.7 and 16.8 per 1,000 people. The infant mortality rate per 1,000 live births was 91 in 2000. The total fertility rate has steadily declined to 4.4 children per woman in 2000. Of married women aged 15–49, contraceptives were used by 23% as of 2000. Estimated life expectancy in 2000 was 44 years.
The AIDS crisis in Lesotho is severe. At the end of 2001, the number of people living with HIV/AIDS was estimated at 360,000 (including 18% of the adult population) and deaths from AIDS that year were estimated at 25,000. HIV prevalence in 1999 was 23.57 per 100 adults. By 2003, the HIV/AIDS prevalence rate was estimated at 31%.