- Pepfar says will also no longer pay taxes, such as the Sh100 million tax on ARVs and other HIV commodities that was demanded by the Kenya Revenue Authority last year.
- Pepfar contributes over 50 per cent of total HIV/Aids funds in Kenya every year. The rest comes from Global Fund, while the government mainly pays salaries of health workers involved in HIV response.
United States has proposed a massive cut to its annual funding for Kenya’s HIV programmes.
The US President's Emergency Plan for Aids Relief (Pepfar) complained Kenya has become one of its biggest beneficiaries since 2003 but is doing too little to increase domestic funding to fight HIV.
This year, Pepfar said it will cut its funding to Kenya by Sh2.27 billion.
Pepfar proposes to give Kenya $345 million (Sh39.17 billion), compared to $365 million (Sh41.44 billion) in 2021.
Acting Pepfar boss Dr Angeli Achrekar said Kenya must take up more responsibilities such as viral load tests for children.
“Pepfar Kenya has one of the largest programmes and budgets, but falls in the bottom third when it comes to host country government co-financing,” she said in a planning letter, seen by Star, to the acting US ambassador to Kenya Eric Kneedler.
She added, “Now that Pepfar Kenya’s focus is shifting to sustaining its HIV impact, the co-financing commitments and follow-through need to be a priority."
She also warned Pepfar-funded programmes in Kenya must not hire extra staff and some jobs will be merged.
The donor works through the National Aids Control Council, the National Aids and STIs Control Programme and about 100 other implementing partners, mainly non-governmental groups.
Angeli said Kenya was already in epidemic control and therefore unnecessary spending must stop.
Epidemic control is reached when the total number of new HIV infections falls below the total number of deaths from all causes among HIV-positive individuals.
“Pepfar Kenya should review non-service delivery spending to identify duplicative activities that can be consolidated or centralised. Staff and material spending at site should be reviewed with a preference for maintaining current levels,” she said.
Angeli said they will also no longer pay taxes, such as the Sh100 million tax on ARVs and other HIV commodities that was demanded by the Kenya Revenue Authority last year.
This stand off led to a six-month stockout of ARVs and testing kits across the country.
KRA demand came after Pepfar bypassed the Kenya Medical Supplies Authority and exported ARVs to Kenya through a private US company, called Chemonics, which also wants to take over drugs distribution in Kenya.
“The stockout of commodities Kenya experienced last year is unacceptable,” she said.
“US-donated commodities should continue to be allowed to enter Kenya tax-free and approvals for commodities to enter the country should continue to be granted swiftly so that commodities are not diverted or wasted,” Angeli added.
Angeli’s letter will guide the Pepfar Country Operational Plan (COP), which describes detailed priorities and strategies that will direct the funding for the Aids response in Kenya in 2022.
Government officials and civil society groups have been meeting this week to discuss the letter and craft this plan.
Nascop boss Rose Wafula and Nacc director Ruth Masha are attending the meeting in Nairobi.
Angeli said March 2022, Pepfar will convene a virtual meeting where outstanding decisions will be discussed and finalised.
People living with HIV urged the government to increase funding and bridge the gap left. “We are expressing worry but we hope the Kenya government steps in and increases allocation to cover the gap being left by the Pepfar,” Nelson Otwoma, head of the HIV lobby Nephak said.
HIV funding from Pepfar has been reducing since 2018, without any notable increase from the Kenyan government.
Pepfar stopped funding the Kenya National Blood Transfusion Service in 2018, but the Kenyan government is yet to up its funding, leading to the current shortage of donated blood in hospitals.
In 2017, Pepfar gave Kenya $570 million, which was reduced to $500 million in 2018, and further to $370 million in 2019.
In 2020, The amount slightly rose to $375 million, but dropped to $365 million in 2021 and $345 million this year.
Pepfar contributes over 50 per cent of total HIV/Aids funds in Kenya every year.
The rest comes from Global Fund, while the government mainly pays salaries of health workers involved in HIV response.