KIPTUM: Kenya on track to achieve HIV goals despite Covid setbacks

That Covid-19 left an indelible mark on our collective psyche is unquestionable. The pandemic swept across the globe leading to the closure of workplaces and entertainment spots and causing millions of deaths all over the World. The mental strain caused by job losses, restricted mobility and general health concerns were exacerbated.

As a pandemic, its impact on healthcare systems was immediate and severe. Hospital beds were full, and in some cases, all but the most urgent health issues were encouraged to wait it out. People living with HIV-Aids were among the most affected because the virus does not have the same immediacy as Covid-19, requiring their care to become secondary for some time.

Additionally, the Covid-19 control measures seriously impacted global, regional, and local supply chain to the extent that anti-retroviral drugs, which are critical to suppressing HIV’s viral load in people living with the virus, were in short supply. The supply chain issues even went as far as disrupting the availability of the laboratory reagents used in testing for HIV, in turn slowing down testing among high-risk groups.

Fortunately, the pandemic struck at a time when Kenya was making great strides toward its goal of eliminating HIV-Aids by 2030. Despite the disruption caused by the novel coronavirus, the country saw a 68.5 per cent reduction in new infections and a 43 per cent reduction in Aids-related deaths between 2013 and 2021, according to the Kenya World Aids Day Progress Report 2013-2021.

This positive progress can be attributed to several factors, including increased and consistent public spending on HIV response and treatment, increased testing rates across the country, and increased access to anti-retroviral drugs and other care programmes.

The first HIV case in Kenya was reported in 1984, and in just 10 years, the prevalence rate had reached a peak of 10.5 per cent of the general population. Kenya then increased efforts to increase access to anti-retroviral therapy and reduce the number of new infections, which, when combined with the high Aids-related mortality rate at the time, resulted in a downward trend in the virus's prevalence.

According to the National Aids Control Council, Kenya's HIV-positive population stood at 1.43 million in 2021, indicating that the combined efforts of the public and private sectors have yielded significant results.

Improving access to information for both the public and medical professionals was a key component of the drive to reduce new infections and increase treatment uptake, with the goal of not only encouraging more people to get tested, but also reducing the stigma associated with the disease.

Pregnant women, for example, have benefited greatly from HIV-Aids awareness campaigns, with at least nine out of every 10 pregnant women being tested for the virus and eight out of 10 infants born to HIV-positive mothers being placed on prophylaxis.

According to the World Aids Day Report 2013-2021, mother-to-child transmissions have decreased from 13.9 per cent in 2013 to 9.7 per cent in 2021. This equates to 65,000 fewer new cases among children, resulting in the current 78,465 children under the age of 15 living with HIV in Kenya.

The inclusion of sexual health education in primary and secondary school curricula greatly increased awareness of the disease, its risks, and treatments. Conversations about the virus became more mainstream in and beyond mainstream media. Some of the public information campaigns were so effective that anyone who watched television in the early 2000s recalls the late President Mwai Kibaki telling us, "pamoja tuangamize ukimwi".

Despite the commendable progress, we should not rest on our laurels for a single moment. If the Covid-19 pandemic taught us anything, it was that progress can be halted very quickly.

In 2020, the United Nations Children's Fund (Unicef) warned that the Covid-19 pandemic, with its resulting school closures, financial hardship, mental stress and general insecurity, created conditions for increased abuse, sexual violence and transactional sex, which increases the chances of HIV transmission among adolescents.

To achieve the goals that we have set for ourselves as a country, we must not relent in our efforts to eliminate new infections and prevent Aids-related deaths. Keeping the momentum going will necessitate concerted efforts from the private, public, and even individual sectors as we work to meet the goals of the Kenya Aids Strategic Framework 2020-2025, on our way to ending Aids as an epidemic by 2030.

Chief paediatrician at Gertrude’s Children’s Hospital