By Chemtai Kirui
The fight against HIV/AIDS in Kenya has seen significant progress, with a decline in the number of children living with HIV and mother-to-child transmission according to a report by UNICEF.
The country has made strides in the fight, with the number of children living with HIV dropping from 180,000 in 2010 to 111,500 in 2020. Improved access to services, particularly for pregnant women, was a factor in the reduction of cases. However, young people aged 15-24 remain at risk, accounting for 35% of new infections in 2020, with two-thirds of those cases among young women.
Kenya is also facing what has been termed “triple threats” to the health of its young people: HIV infections, adolescent pregnancies, and sexual and gender-based violence (SGBV).
The National Syndemic Diseases Control Council (NSDC) report of 2022 found that 52% of new HIV infections were among adolescents and young adults aged 15-29, with a majority of these cases among girls and young women. The report identified female genital mutilation (FGM), SGBV, and teenage pregnancies as threats that predispose girls in Kenya and globally to HIV/AIDS.
The Kenyan government pledged to co-finance Sh1.2 billion ($10 million) to the kitty, an increase of 66% from Sh723 million ($6 million) made in 2019. The efforts in the health sector have been recognized in the MOH’s National and County Health Budget Analysis for the year 2020/21. This report, which was externally funded by USAID and PEPFAR, notes that the government is taking on a more active role.
Although there has been funding, in the last three fiscal years alone, donor contributions to HIV/AIDS, TB, and malaria through the Ministry of Health budget have each decreased by almost 35%.
Dr Ruth Masha, the lead Global Fund proposal development for Kenya, and the CEO National Syndemic Diseases Control Council (NSDC) said the situation is dire if the trend continues unmitigated.
“For HIV support, the signs are on the wall, and we must think differently, for example, negotiate how to get the drugs. Right now, there is fear of what happens tomorrow,” she said.
The Kenyan government has been utilizing digital technologies to improve access to treatment and care for all pregnant and breastfeeding women, as well as providing universal testing and treatment for all children and adolescents living with HIV. Currently, around 1.2 million people living with HIV/AIDS are under antiretroviral therapies, while 200,000 others, mostly children, are not, according to government statistics.
Although new HIV infections remain high, reports say they have significantly reduced over the years, with approximately 95 cases per day in 2022, down from 278 per day in 2013. The number of annual cases of mother-to-child transmission has also halved from about 12,940 to 5,160 between 2013 and 2022.
Despite these improvements, there is still much work to be done. Experts warn that relying entirely on external life-saving commodities is not sustainable, and Kenya must have a difficult conversation on the structure, form, choice, and scope of its health funding.
Experts say domestic finances for health are urgently needed, and Kenya must address inefficiencies and corruption in the health sector to make progress in the fight against HIV/AIDS.
Dr. Rose Oronje, the Director of Public Policy & Knowledge Translation & Head of AFIDEP Kenya Office, says that, “Kenya’s budget is growing, but most of it is going towards recurrent expenditure.”
Oronje recommends increasing the allocation to primary healthcare (PHC), which remains minimal despite its criticality to health outcomes.
Although county governments are the primary custodians of health function, recent African Institute for Development Policy (AFIDEP) research indicates that the 28% of the budget they are dedicating to health is still lower than the 35% allocation pre-devolution.
Kenya is among the 12 countries with high HIV burdens that have joined the Global Alliance to end AIDS in children.
Experts agree that additional domestic finances for health are urgently needed if Kenya is going to score significant gains in 2023. Besides, Kenya has to curb wastage, address inefficiencies and corruption in the health sector.
“It’s not all doom and gloom, there are countries that have gotten it right, and we can learn from them,” says Oronje.
The government’s pledge to co-finance the Global Alliance to end AIDS in children is a step in the right direction, but additional domestic finances for health are urgently needed to achieve significant gains.
The Kenyan government is committed to ending the AIDS epidemic by 2030, but more needs to be done to address the root causes of the epidemic, including sexual and gender-based violence and teenage pregnancies.