Important note: Information in this article was accurate in 2009. The state of the art may have changed since the publication date.
Integrated Regional Information Networks - November 10, 2009
James Ole Kiyapi, permanent secretary in the Ministry of Medical Services and chair of Kenya's country coordinating mechanism, who is responsible for submitting grant proposals to the Fund, said the main reason for the TRP's recommendation was that Kenya's two ministries of health had failed to properly coordinate the management of resources.
In 2008 Kenya split its health ministry into the Ministry of Public Health and Sanitation, and the Ministry of Medical Services. Local media have reported wrangling over roles and access to financing - at one point both ministries appointed someone as head of the National AIDS and Sexually Transmitted Infections Control Programme, a major HIV/AIDS body.
The final decision on the recommendations of the TRP lies with the Global Fund Board, which is meeting in Addis Ababa, Ethiopia.
A high-powered delegation has been sent to appeal the decision. "We hope our side of the story will be heard," said Ole Kiyapi. The country is requesting US$270 million from the Fund.
Kenya's 2008 proposals for funding for HIV, TB and malaria were also rejected; in 2003 the Global Fund delayed the disbursement of funds over concerns about corruption in the National AIDS Control Council.
Analysts say a recent row among HIV/AIDS NGOs over funding could also have played a part in the TRP's decision.
"We as a country have done a shoddy job of managing previous funds. Let this be a wake-up call, and let us learn from our mistakes and tackle the problems that have put us here in the first place," said James Kamau, head of the Kenya Treatment Access Movement, a national advocacy group.
Aidspan, an independent watchdog of the Global Fund, gives Kenya a 'D' in terms of grant performance, noting that on average Kenya grants are almost nine months behind schedule.
"If the bid is rejected outright people will die, because the government itself contributes nothing to HIV treatment in this country," Kamau said, adding that the government should start funding its own HIV programmes rather than relying so heavily on donors in order to avoid such uncertainty in the future.
The Global Fund, Kenya's biggest HIV/AIDS donor, has contributed over US$87 million to prevention, treatment and care programmes; more than 200,000 Kenyans are receiving antiretroviral medication.
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