The MCC "compact" Lesotho is unfortunately in keeping with US aid policies in that meaningful interventions involving recurrent costs of salaries, salary increases, and incentives are not covered. Although MCC was asked to consider funding emergency retention measures, the money instead is limited almost entirely to capital expenses & brick and mortar projects. For example, instead of paying for salaries or incentives for tutors, there are dorms. Many schools of nursing, including the one in the area were MSF work, are suspending programs and limiting students because of lack of tutors. The Lesotho government will again make an appeal to donors to assist with the remuneration of tutors. Otherwise the dorms that were just completed (from a previous donor who favored capital over recurrent costs) to house 200 additional students will stand empty and useless. Instead of incentives (like transport or hardship allowances or top-ups) for nurses working in primary care clinics (almost all are "rural" in Lesotho), there will be-- to quote on of the MCC-hired architects "perfectly good roofs taken off the clinics to put excellent roofs on." Filling the vacancies and retaining the workers in clinics is the problem, but MCC funding does not go to that. Representatives of MCC and the US embassy were told time and again: there are many good clinics, with strong infrastructure, but that are empty of staff. MSF works in 14 primary care clinics (6 in the highlands) and one district hospital. The vacancy rates at the clinics of professional nurses is 54%. At the hospital, it's better at 30%. This is a lot better than other areas in Lesotho, but is getting progressively worse everywhere. In the government report on its progress to address the HR gaps, they say the most "fruitful" HR strategy thus far has been task-shifting, including to CHWs. This should not to be read as good news. The Health Sector Project is designed to mitigate the negative economic impacts of poor maternal health, HIV/AIDS, tuberculosis ("TB") and other diseases by substantially strengthening the country's health care infrastructure and human resources for health capacity. MCC funding will support Lesotho's efforts to significantly increase access to life-extending anti-retroviral therapy ("ART") by providing a sustainable platform to deliver this and other essential health services throughout the country. This has the potential to result in a measurable extension of productive life-years for people living with HIV/AIDS, TB and other debilitating diseases. The Health Sector Project activities include the renovation of up to 150 health centers in order to establish a na-tional stock of health centers that achieve a common standard; the establishment of ART clinics in and improved management of up to 14 hospital out-patient departments; the construction and equipping of a new central laboratory and training for laboratory staff; the construction of a dedicated, central facility for collecting and processing blood and the provision of mobile blood collection and storage equipment; an increase in the number of dormitories and staff residences at Lesotho's National Health Training College; the strengthening of health systems through increased capacity for pre-service and in-service nurse training and improved district-level public health human resources management.