HIV-AIDS

ARV surveillance system robust

Pushed Kenya steadily towards the global 90-90-90 targets.

In Summary
  • Ensuring availability of ARVs and commodities for HIV and other health conditions requires significant health sector coordination, communication and efficiency.
  • A multi-disciplinary forecasting and quantification committee meets quarterly to review and determine stocking levels.

The Kenyan HIV and Aids response has made great strides and has received international recognition.  Since 2013, new adult HIV infections have fallen from more than 101,000 per year to 45,000 in 2018.  The number of people living with HIV who are enrolled in lifelong anti-retroviral therapy is more than 1 million of the estimated 1.5 million living with HIV. 

The Ministry of Health policy of test and treat, implemented by the National Aids and STI Control Programme, increased the number of people diagnosed HIV positive after treatment and who have been enrolled into ARV treatment.  This has pushed Kenya steadily towards the global 90-90-90 targets, whose goal is to have 90 per cent of estimated HIV positive people diagnosed, 90 per cent of those adhering to medication and 90 per cent achieving viral suppression.

Consistent availability of ARVs and adherence among those who initiate has been key to an improved quality of health and led to a 52 per cent reduction in Aids related deaths. 

Ensuring availability of ARVs and commodities for HIV and other health conditions requires significant health sector coordination, communication and efficiency. The government has in place robust surveillance and response mechanisms. 

A multi-disciplinary forecasting and quantification committee meets quarterly to review and determine stocking levels. This includes Dolutegravir, the ARV drug with fewer side effects and better adherence that the government has initiated. 

Procurement and distribution of HIV commodities, including test kits and laboratory reagents, is the function of the specialised agency that responds to draw-down requests made by counties and hospitals based on their utilisation and needs. 

Data analysis to inform decision-making is conducted routinely through the multi-disciplinary Strategic Information Committee that is housed at the NACC. To make sense of all this information, the Kenya HIV and Health analytics platform, popularly called the HIV and Health Situation, was implemented.

Utilisation is reported monthly from all health facilities through a data capture system called the DHIS2, a system managed by the Ministry of Health which provides data on number of people provided with each different service. These are aggregated by facility, county and disease area to facilitate tracking of progress towards national targets as outlined in the Kenya Aids Strategic Framework and in our global obligations. 

Services provided in communities by the 3,140 Community Based HIV Service Organisations and NGOs are reported monthly through the NACC-managed Community Aids Progress Reporting tool, enhancing monitoring of services. Quality control of these data is undertaken through bi-annual Data Quality Assurance Audits done by a joint team of counties and national government Ministry of Health officials. 

Data analysis to inform decision-making is conducted routinely through the multi-disciplinary Strategic Information Committee that is housed at the NACC. To make sense of all this information, the Kenya HIV and Health analytics platform, popularly called the HIV and Health Situation, was implemented.

This is an Artificial Intelligence data system that draws data online from all these systems, reducing the need for paper reporting. This system provides easy-to-read maps and tabulated combined reports on services uptake, commodity statuses and progress to date.

These reports, as may be required, are presented at the Inter-agency HIV Committee, which is chaired by the NACC and draws government, donors, NGOs and community representatives, together with the faith sector and private sector, for review and action. Further, county HIV committees are availed with relevant data for decision-making. 

These systems, while run by different agencies, are coordinated to ensure continuous monitoring of HIV services and commodities, including ARVs. As Kenya moves towards UHC, the Cabinet Secretary is ensuring that the working systems that are already in place are being leveraged for broader healthcare and tracking, monitoring of expanded health conditions.  This will contribute towards gaining more health for the money that is available to provide every Kenyan with affordable healthcare.

CEO, National Aids Control Council