More than 400 Kenyan AIDS activists have demonstrated in the capital, Nairobi, demanding that the US President's Emergency Plan for AIDS Relief release some US$500 million for HIV programmes in Kenya that is stuck in the pipeline.
The US government recently revealed that close to $1.5 billion has been in the global PEPFAR pipeline for more than 18 months. The allocation to Kenya is the largest.
"We are protesting the US government's withholding of crucial funding for HIV programmes in the country. Last year, [special programmes minister] Esther Murugi pledged that the government would put one million Kenyans on HIV treatment by 2015 - without this funding, that goal cannot be achieved," said Rose Kaberia, director of the International Treatment Preparedness Coalition (ITPC) in Eastern Africa.
The protestors presented a memorandum listing their demands to US Ambassador to Kenya Scott Gration, head of PEPFAR-Kenya Katherine Perry, Kenya's Director of Public Health, Shahnaz Sharif, and other senior Ministry of Health Officials.
The unspent money has led US President Barack Obama's government to request a $550 million cut in PEPFAR's global funding under the 2013 budget. Activists have expressed concern that a slow-down in global HIV funding could put lives at risk.
Kenya expected a 44 percent cut in PEPFAR funding for national programmes, so the PEPFAR country operational plan for 2013 keeps enrolment on HIV treatment at the 2011 figure of 100,000 new initiations annually.
In the past year, several NGOs have raised the alarm over dwindling funds for HIV programmes around the country, with some having to shut down clinics and offices providing HIV treatment.
"We have ARV [antiretroviral] shortages... the worst part is that it disrupts people's HIV treatment regimens, yet treatment for HIV is only effective when it is consistent," a nurse at Kisumu District Hospital in western Kenya told IRIN/PlusNews.
"The Kenyan government needs to ask for these funds, and the US government needs to say, ‘Yes’," said Paul Davis, director of global campaigns for US advocacy group Health Global Access Project.
Peter Cherutich, acting head of the National AIDS and STI (sexually transmitted infections) Control Programme (NASCOP), told IRIN/PlusNews that the Kenyan government had not been aware of the unspent money until recently.
"This news came as a surprise to us. The way PEPFAR's country operational plans work, the disbursements tend to be delayed - that is likely to be the cause of the money stuck at the US treasury," he told IRIN/PlusNews. "We will be meeting the US government to negotiate the urgent release of the funds, which are crucial to our HIV treatment and prevention activities - we are starting a dialogue."
US Global AIDS coordinator Eric Goosby noted in an interview with the health blog, Global Post, that one of the reasons for such a large amount of unspent money for Kenya was the country’s two health ministries - one for medical services and the other for public health - which "definitely slowed things down".
"The need in programmes that deliver life-sustaining or life-saving services is that you want to have a redundancy in the flow of money, so if the money isn't there, or if the appropriation is delayed - as you've seen over and over - by months, the service doesn't stop," the blog quoted Goosby as saying. "We had built in, as a policy, a 12-to-18-month period, which means you can keep a 12-to-18-month pipeline. I feel comfortable with that, it's responsible. Any more than that, it's not; any less than that, I'm worried that you are vulnerable."
|The Kenyan government needs to ask for these funds, and the US governmnt needs to say "Yes"|
ITPC's Kaberia noted that the money was all the more necessary since the UN World Health Organization had recently issued new guidelines on treatment options for the prevention of mother-to-child transmission and discordant couples, in which one partner is HIV positive and the other is not.
"As we now know, treatment is prevention, and more people on treatment means fewer HIV infections; we will need money to implement these new treatment and prevention programmes," she said.
Modelling by the US Centres for Disease Control indicates that accelerating the enrolment of patients to meet Kenya's target of having one million persons who need it on treatment by 2015 would cut new HIV infections by over 31 percent in the same period.