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Kenya needs local HIV interventions

NAIROBI, Kenya, Mar 23 – The National AIDS Control Council (NACC) is asking the government to focus on domestic interventions to curb and contain the HIV scourge and stop over reliance on external funding.

The agency pointed out that the government started financing HIV related programmes last year with an allocation of Sh500 million, but said it must come up with sustainable and innovative measures to fund the fight against the pandemic.

The Head of Strategy Development at the NACC Regina Ombam said on Tuesday that currently, Kenya’s assured donor support (in the war against HIV/AIDS) would end in 2011 when funding from round seven of the Global Fund to fight HIV, Tuberculosis and Malaria would be terminated.

“We are not going to sit and say since we have money up to 2011 let’s wait and see how it goes. Can we start thinking of ways to ensure we have enough finances to continue giving ARTs (Antiretroviral Treatment)? The global crisis affected most of our partners so if we are still thinking of going back to them to ask for money while they have their own problems then I think we are making a huge mistake,” she said.   
 
Ms Ombam who projected that the number of HIV infected adults who are in need of ARVs currently stood at 500,000 also asked the government to fill the $1.67 billion gap which would facilitate HIV treatment over a four-year period. She explained that after costing its strategic plan the institution found out that treatment measures took a big component of the country’s total HIV budget allocations.

“By 2015 HIV positive adults in need of ARVs will be about 700,000 and we need to scale up our intervention measures. What’s the point of asking people to get tested if we can’t provide treatment? We realise that we still have a funding gap out of which $959 million is needed for treatment where ART falls in,” she said.

She also proposed that if the government modestly increased the insurance premiums through the National Hospital Insurance Fund, it could reduce the financing pressure on treatment and care pillar of HIV patients.

“If we are thinking of something that Kenya has to do in the immediate future then we should ensure that NHIF is reformed; that we start looking at it as a social insurance firm which takes into account the population of Kenyans and covers as many people as possible at a reasonable rate,” she said.

She explained that if premiums given by NHIF were increased to 25 percent then the country would be able to fund a quarter of what was needed in terms of ARVs (Antiretrovirals) and treatment mechanisms for Opportunistic Infections.

Ms Ombam further proposed that the government introduces special levies on airline traffic and airtime to help it increase budgetary allocations to the HIV intervention measures saying there were about seven countries that were currently applying the levy. She added that Kenya had also pledged her intention of introducing it.

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“We could introduce the levy either to those who are leaving and those coming in or we could put a levy on all passengers as well as freight. Looking at a moderate scenario we are proposing that we tax passengers $2.5 on their air tickets and $0.05 for cargo. On airtime we are proposing a two percent tax; we project that this will help mobilise $153 million over a four year period ending mid 2015,” she said.

She asked the government to decentralize and expand the provision of HIV services saying that it was concentrated in tertiary healthcare facilities which limited access of the vital services by Kenyans in rural areas.

She further said the country still battled with stigmatization associated with the disease which hindered the fight against it.

“We have marriage cases where the men force their wives to get tested and if she turns positive and embarks on her treatment schedule, then the man starts using her drugs. So you find that such men would rather not go get tested themselves and when they start taking their wives’ drugs, he is essentially interfering with her treatment regime which is not good,” she explained.

Ms Ombam also asked Kenyans and their government to refrain from blaming donors who attached conditions to their aid saying Kenyans needed to figure out why donors put conditions to their funding.

“Why should I put something in a place which already has a glaring risk in it? We force people to give us conditions. So we must look at how we harmonise the ministries responsible for health how they are governed and ensure that we are very clear on commodity supply. That way we will be able to get more support. It’s very simple put your house in order and you will be able to get what you need,” she said.

Ms Ombam also explained that NACC would forward their proposals to the Cabinet for consideration in this year’s budget.

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