This document introduces the PPP legal and institutional framework of Lesotho.

This report finds that private participation in infrastructure could offer Lesotho three key advantages: (1) augmenting budget resources in cases where the private sector undertakes to finance projects or services that would not otherwise be funded, (2) improving the quality and efficiency of service delivery, and (3) accelerating investments in infrastructure.

The Kingdom of Lesotho, a small landlocked country with a population of two mil- lion, has faced increasing demand to its health-care system because of AIDS, economic challenges and declining resources available for health care. In response, the govern- ment embarked on a long-term reform process to improve the efficiency of the sector. As part of this effort, it turned to the private sector to create a sustainable heath-care waste management system that protects public health and the environment.

For many years, Lesotho has urgently needed to replace its main public hospital, Queen Elizabeth II. In 2006, to maximize the use of limited resources and ensure long-term improvement in facilities and services, the government adopted the public-private partnership (PPP) approach for a new hospital.

The Ministry of Finance released a PPP Policy in 2017. The purpose of the Policy Framework is to set out the Government of Lesotho’s rationale for the adoption of PPPs, its objectives associated with the application of PPPs, the envisioned PPP strategies, options, techniques, and the key considerations concerning the institutional establishment, implementation, and management of PPPs in Lesotho.

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