Kenya: Funding cuts threaten HIV / AIDS treatment efforts
People living with HIV fear losing access to free treatment services as Kenya heads into crisis as donor funding shrinks due to insufficient domestic funds, NationNewsplex review reveals HIV funding .
The misuse of available resources has worsened the situation in a sub-sector heavily dependent on donor funding. Donor spending on HIV programs was more than double that of the government in 2017, according to a study by experts from Strathmore University, the World Bank’s country office in Kenya and the United Nations. ‘Duke University in the United States.
The recently published study reveals that the US President’s Emergency Plan for AIDS Relief (Pepfar) is the main funder of the HIV response in Kenya, contributing more than half of the funds. HIV / AIDS total and over 80% of funding from external sources since 2012.
But Pepfar has cut its disbursements to Kenya by nearly three-quarters in four years, from 17.3 billion shillings in 2016 to 4.9 billion shillings in 2019. Overall spending by the US government on anti-cancer programs HIV / AIDS in Kenya also fell six percent from 42.1 billion shillings in 2016 to 39.7 billion shillings in 2019, figures from the United States Agency for International Development (USAID ).
Overall, external financing represents at least half of public health expenditure.
The decline in donor support for HIV programs has alarmed people living with HIV like Nancy Mwashigadi. The 49-year-old man has been living with HIV for 17 years. “Last year we were hit by a shortage of Septrin, a drug that helps prevent opportunistic infections. Many of us also lost our jobs and relied on supporters for food donations, ”Ms. Mwashigadi explains.
Although the situation has improved this year, the community health worker is concerned about the drop in funds. “Right now we are given ARVs for a month compared to previous years where we could get drugs for three months. People with HIV used to get free treatment for other illnesses, but now when you go to the hospital you are told you can only get ARVs and Septrin, ”she says.
Dr Catherine Ngugi, program manager at the National AIDS and STI Control Program, says a client on first-line ARVs uses around Sh 7,000 but if switching to second-line drugs it would cost around 19 000 Sh and 16,000 Sh for a child. . A patient can develop resistance to first-line drugs if they do not adhere to the prescribed treatment.
“It’s only about the products and not the operational costs. About 85% of spending on HIV and AIDS programs comes from donors. With the government now providing money, we will soon become self-reliant, ”she said.
Dr Ngugi says the government is hiring local manufacturers to produce the drugs in the country to help reduce costs, so that external funding can be used for programmatic activities and not to purchase drugs and other products.
Uganda already manufactures ARVs and exports them to other African countries.
However, Kenya Private Sector Alliance chairman Patrick Obath says for this to happen it is necessary to tackle the cost of electricity and transport.
“The intellectual capacity is there, but all these obstacles make it impossible to manufacture these drugs. Uganda already manufactures ARVs and exports them to other African countries, but they have had to overcome many obstacles to get to where they are now, ”he says. .
A report released by Health Policy Plus, an organization that advances health policy priorities, shows that the nominal public allocation for health has increased over time, but not enough to compensate for reduced donor spending. In addition, the proportion of the total government budget (national and departmental) allocated to health is always lower than national commitments, while major national strategic programs, such as HIV and malaria, rely heavily on donor support.
An analysis of national and county budgets by the Ministry of Health for the fiscal years between 2013/14 and 2019/20, shows that the share of the public budget allocated to health increased from 7.8% during the period. 2012/13 fiscal year at 5.5 percent. one hundred during the transition year of decentralization. The proportion then gradually increased to peak at 9.5% in fiscal year 2018/19 before declining slightly to 9.1% the following year.
During the period under review, the share of the public budget allocated to health remained below the 15% recommended in the Abuja Declaration.
Speaking during the 2021/2022 budget reading to Parliament, Cabinet Secretary to the Treasury Ukur Yatani said Kenya has allocated 5.8 billion shillings to fund HIV / AIDS programs, an amount that experts and activists consider insufficient.
“We need around 25 billion shillings to deliver ARV drugs and other life-saving supplies to Kenyans who need them, so it’s a drop in the ocean,” said Dr Vernon Mochache. , Deputy Director of Research at the National AIDS Council.
However, he said, it is encouraging that the government has put money aside for HIV / AIDS for the first time.
According to Dr Adel Ottoman, director of preventive and promotional health services in Homa Bay County, delays in the disbursement of funds by the national government are a problem.
“They send the money when the time is almost up, so we don’t have enough time to implement our plans. The budget is read in June but the first disbursement comes in October,” says Dr Ottoman.
A statement released on June 14 this year by Chairman of the Board of Governors Martin Wambora revealed that the Treasury had not yet disbursed the county governments in the amount of 102.6 billion shillings at two weeks of the end of the 2020/2021 financial year. The shortfall has affected the delivery of public services, including health care, by county governments.
The Treasury released 43.5 billion shillings, or 42% of the sums due, on June 23, just one day before the deadline set by the governors for the cessation of operations.
Among the more than 1.4 million people living with HIV in Kenya is Ms. Mary Waceke, 58, a widow who hopes she will not miss the life-saving drugs that have kept her alive since 2007.
“Whenever I look at the news about the reduction in funding for HIV projects, I fear that one day I will go to the clinic and be told there are no drugs. . I hope the government will fix this problem. I have no choice but to trust in God, ”she said.