UN Integrated Regional Information System - October 29, 2008

"We are too dependent on donor funding for programmes like these [related to HIV, malaria and tuberculosis], which are vital to the health of our people - we must start becoming more self-reliant," Danson Mungatana, Assistant Minister for Medical services, said on 27 October.

Although the Global Fund's Technical Review Panel recommended that Kenya's proposal be rejected, the final decision lies with the Fund's board of directors, due to meet in India in November; however, the board has never disagreed with the review panel.

Mungatana noted that the rejection in the Fund's eighth round of funding was unlikely to have an immediate effect, as the money from the previous round of funding would last until 2010. Kenya had applied for US$130 million for HIV programmes, $100 million for malaria and $70 million for tuberculosis.

An estimated 98 percent of Kenya's AIDS programmes are donor funded; no funds were set aside for HIV and AIDS in the country's national budget announced in July.

"For us as a country, we need to ask ourselves, is this sustainable? It is not," Mungatana said. "We are making a direct appeal that the treasury now must start to prioritise our issues."

Stop-gap

As a stop-gap measure, the minister announced that 500 million shillings ($6.25 million) of government money had been set aside to buy ARVs through the Kenya Medical Supplies Agency. "But this is still a small amount compared with what will be needed after 2010. We must do whatever it takes to make sure that no one is taken off ARVs."

The Global Fund is one of the largest supporters of Kenya's AIDS programmes, providing an estimated $100 million every year; the US President's Emergency Plan for AIDS Relief, PEPFAR, provides about $200 million annually.

James Kamau, head of Kenya Treatment Access Movement, a national advocacy group, said it was time the government took up its obligation to provide health services to all Kenyan citizens.

"The government of Kenya has never bought a single ARV," he told IRIN/PlusNews. "But it is the government's responsibility and not the donors' to keep the population alive and well.

"The Global Fund's decisions to provide support are performance-based, and we need to ensure that we improve our management and meet their standards, so that we do not run into the same problems again," Mungatana said.

As the government attempts to address the reasons for the eighth round rejection, Kenya's Minister for Medical Services, Anyang' Nyong'o, has called for the immediate suspension of proposals for the ninth round of funding due to be submitted by 21 January 2009.

The government has experienced difficulties with its Global Fund proposals in the past; in 2003, $37 million was delayed after claims of corruption in the National AIDS Control Council.

Kenya has approximately 220,000 people on ARVs, just under half the number thought to need the life-prolonging medication. The country's HIV prevalence recently took an upturn, going up from 5.1 percent in 2006 to 7.8 percent in 2008.

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