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Inter Press Service - July 26, 2005
Joyce Mulama
NAIROBI, Jul 26 (IPS) - For those Kenyans who have contracted HIV, getting access to anti-retroviral drugs (ARVs) is seldom an easy matter. In the case of children, however, the situation is even more problematic.
According to Health Minister Charity Ngilu, only 1,200 of the 44,000 people receiving free ARVs in Kenya are children -- far below the 10 percent of HIV-positive children who are thought to be in need of treatment.
This situation is repeated at a global level. Statistics from the World Health Organisation (WHO) indicate that children account for almost 17 percent of AIDS-related deaths annually (some 500,000 in 2004) -- but receive less than five percent of AIDS medication.
In large part, these disparities result from the fact that paediatric ARVs are more expensive than those used for adults, says Ngilu: in Kenya, the drugs can cost five times as much as the ARVs administered to adults.
But, they probably also reflect the fact that Kenya has too few medical staff who are trained to dispense the drugs to children. Reports indicate that few paediatricians in developing countries have experience in treating children for AIDS.
"We not only have an acute shortage of healthcare workers to satisfy the current demand for health services in Kenya, but we also have a skills gap that needs to be addressed in order to be able to provide quality health care," Ngilu said this weekend (Jul. 23) at the launch of the Clinton Foundation Paediatric HIV/AIDS Initiative in Kenya.
The project, undertaken with the Ministry of Health, aims to provide AIDS medication to another 1,000 Kenyan children who are HIV-positive by the end of 2005. It forms part of a broader campaign on the part of the Clinton Foundation, established in 2001 by former U.S. president Bill Clinton, to help address the effects of the HIV pandemic in Africa, Asia and the Caribbean. Globally, the organisation is seeking to put an additional 10,000 HIV-positive children on ARVs by the end of the year.
Clinton was also present at the launch, held at Mbagathi district hospital on the outskirts of the capital, Nairobi.
"The war against HIV/AIDS will only be won if HIV/AIDS care for children is addressed," he told those at the gathering. Clinton's visit to Kenya formed part of a six-nation tour that had already taken him to Tanzania, Mozambique, Lesotho and South Africa. Rwanda was scheduled to be the final stop on the former president's itinerary.
In another address delivered at the launch, Sally Agalo, a woman living with AIDS, spoke of the transformative power of ARVs.
"I am a living testimony that ART (anti-retroviral therapy) works," she said at the gathering.
"I was diagnosed with HIV/AIDS in 1999 and put on ART in 2003 when my CD4 count was 30 and my weight was 36 kilogrammes. Today, my CD4 count is 450 and my weight is 70 kilogrammes."
A CD4 count gives a measure of the number of blood cells which help ensure immunity to disease.
Under the initiative, the Clinton Foundation will provide paediatric ARVs bought at a steep discount from generic Indian manufacturer Cipla; these are to be dispensed at government ARV sites. A first shipment of the medication has already arrived in Kenya.
The initiative also provides assistance for training medical staff in AIDS care, something that has already got underway. About 120 nurses are due to be sent out to four hospitals in rural areas which suffer from a shortage of health care personnel (most of whom tend to be based in urban areas).
According to the United Nations Development Programme, Kenya has 13 doctors per 100,000 citizens, a ratio far below that of developed countries such as the United States (270 per 100,000) and Norway (413 per 100,000).
The 2004 Report on the global AIDS epidemic, published by the Joint United Nations Programme on HIV/AIDS (UNAIDS), puts HIV prevalence in Kenya at 6.7 percent. About 1.2 million people in the country are estimated to be living with HIV, 100,000 of them children.
In sub-Saharan Africa as a whole, more than 25 million people have contracted HIV -- making it the region worst-affected by the pandemic. More than 60 percent of HIV-positive people live in sub-Saharan Africa, even though the region is home to about 10 percent of the world's population.
The WHO estimates that of the 37.8 million people worldwide living with HIV/AIDS, five to six million in developing countries are in urgent need of ART. However, only 400,000 had access to such treatment by the end of 2003.
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