Global Fund pokes holes in Kenya’s HIV programme

By Gatonye Gathura

The Global Fund has expressed concerns over the high number of HIV patients being lost to treatment in Kenya.

The fund has also questioned Kenya’s capacity to finance its planned scale up of HIV treatment and prevention programme.

Kenya with about 1.1 million patients on antiretrovirals (ARVs) out of an eligible 1.6 million has one of the biggest treatment programmes in the world.

The country is planning to scale up the ARVs coverage to all HIV positive people including to the estimated 70,000 who get infected annually.

There are also plans to put half a million healthy Kenyans on a daily HIV prevention pill within five years.

In a review of its latest funding to Kenya totaling Sh38 billion the Global Fund says the country had failed to show how it’s going to deal with the twin problems.

“The funding request noted declining rates of treatment retention over time but did not describe how the program would address this challenge,” said the Global Fund’s technical review panel in a report last week.

Various reports indicate death, drug toxicity, poor records, indifferent health workers and forgetfulness are some of the reasons patients are being lost to treatment. The highest numbers of patients being lost to treatment are young men.

To retain patients on treatment the Ministry of Health and its partners have extensively turned to text-messaging (SMSs reminders) through mobile phones.

The rationale being that since almost every Kenyan has a phone, periodic SMS reminders to patients would help them adhere to treatment.

But such reminders, a survey among HIV patients in Nairobi published on 18th January says do not work.

The study by among others Amref Health Africa, covered 700 patients on ARVs in Nairobi and reports that SMS reminders have no impact on adherence to treatment

Out of 17 422 text reminders sent out 7718 were never responded with most recipients saying they did not have credit in phones, forgot or were just too busy.

Now Global Fund has asked Kenya to do more to ensure recruited patients remain on treatment.

But the fund has also questioned Kenya’s financial ability to maintain or scale up the HIV treatment programme to meet its own and globally accepted targets.

“Despite progress and plans for continued ARV coverage scale-up, available resources from the 2017–2019 allocation are under extreme pressure,” says the Global Fund report.

A report filed by the Nairobi based Aidspan on the matter on Tuesday says although currently Kenya has sufficient resources to cover the 1.1 million patients on ARVs adding any more would be a challenge.

Despite Kenya overshooting her co-financing requirement by donors, the Global Fund says the country still faces significant budgetary gaps for buying ARVs.

Also the fund has raised concerns over the security of its money in a devolved health system.

In the report the fund has raised issues with oversight complications of its grants presented by devolution of the health sector.

The report however say the National Treasury, the Ministry of Health and the Council of Governors are working on a system that may ensure the donors money will safe in the counties.

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