Civil society Organizations (CSOs) are appealing to the Kenyan government to increase local HIV funding to cover the increasing deficit saying that the decrease in funding for HIV prevention is progressively translating into new HIV infections due to missed opportunities.
Speaking during an HIV Prevention coalition meeting for the dissemination of the CSO HIV prevention shadow report and the HIV prevention multi-sector acceleration plan in Nairobi, Programs Manager Policy and Partnerships &MOSAIC project director, LVCT Health, Patriciah Jeckonia said that the country’s response continues to remain heavily donor funded at 66percent, with only 34 percent covered by the government.
“Kenya currently faces a shortfall of more than US$1.8 billion for its HIV AIDS response over the next five years,” She said adding that, “majority of HIV prevention programs in Kenya continue to be donor funded and targets are largely donor-driven making it difficult to develop a unified set of indicators which speak to all elements of response.
According to Patriciah, Kenya’s continued dependence on donor funding raises concerns about the long-term sustainability of the current HIV response.
“Government needs to work with the civil society organization and other relevant stakeholders to develop and implement a comprehensive domestic resource mobilization strategy for HIV, including prevention. We need to take on the bigger percentage of HIV programs expenditure as a country.”
The CSO’s are urging government to use innovative mechanisms including establishing an HIV Trust Fund, exploring new public-private partnerships and integrating HIV into other services and commodities available under existing health insurance schemes, universal health coverage essential package and primary health care.
The CSO’s are advocating for the government to publish annual HIV budgets and accounts in full including services for key populations and communities so that levels of investment can be tracked and improved over time.
Despite efforts that have been made to reduce the number of new HIV infections, more needs to the done to bring down the numbers among adolescents and young people. According to NSDCC HIV estimates for 2022, 41 percent of new HIV infections occur among adolescents and young people (15-24 years).
Patriciah says that the stakeholders should review if the prevention packages respond to various key and priority populations.
“We should expand national pre-exposure prophylaxis (PrEP) programme to include new HIV prevention technologies like the Ring and long-acting injectable Cabotegravir and roll-out community-based service delivery models for HIV prevention services to curb the new infections and to meet the needs of various populations.”
According to HENNET, Executive Director, Dr Margaret Lubaale, as a country we need to understand what the donor transition means to HIV response and what role stakeholders play to ensure that we don’t lose the gains we have made so far.
“We must ensure that everything is costed so that we know where we are at now and what needs to be done so that we don’t work with assumptions on HIV prevention and treatment,” She added.
While Project Director, Health System Technical Support Unit at the National Syndemic Diseases Control Council (NDSCC) Dr Paul Arimi said that NSDCC is pushing for the inclusion of an HIV package in primary healthcare and the Social Health Insurance Fund (SHIF) and urged CSOs to also join in the advocacy.
He added that HIV prevention is very important to our country and therefore a need to adopt program science and use of data to enhance HIV prevention programs are evidence driven.
He said that we should reduce the new number of infections coming into the pool but the challenge remains how best to communicate HIV information to influence behavior change.
“We don’t know what the contribution of Key populations to the HIV infection rates are and that is why the ongoing IBBS is important.” He said adding that “we should prioritize HIV prevention, care, and support programs beyond the health sectors with clear targets and timelines.
Embrace science and innovation
According to LVCT Health’s, Patriciah Jeckonia, Pharmacy and Poisons Board should expedite approval of long-acting injectable Cabotegravir (CAB PrEP) in order to pave way for generation of implementation evidence that will guide rollout and delivery of the essential HIV prevention technology.
She said that stakeholders should accelerate conversations with government and donors to ensure increase in availability and affordability of the new prevention technologies.
Findings of United for Prevention: Kenya’s Shadow Report
The CSO’s, HIV prevention champions, NASCOP and NSDCC were presented with the HIV Shadow report by LVCT Health on behalf of the United for Prevention Coalition of Kenya.
The key recommendations of the report called for a robust response to the epidemic with Key proposals being full implementation of the national HIV Prevention Acceleration Plan, emphasizing clear roles, responsibilities, and collaboration with civil society.
The report also calls for the completion of the long-overdue Integrated Biological and Behavioral Surveillance (IBBS), ensuring meaningful participation of key and vulnerable populations to ensure programs designed and implemented are aligned to the needs of populations.
It also calls for need to establish a central database to document human rights violations and outcomes from community-led monitoring initiatives and active community and civil society involvement in decision-making for an inclusive and effective HIV response.
