Kenya's progress at reducing HIV/AIDS prevalence could be undermined by funding delays

Although Kenya has recorded a decrease in HIV/AIDS prevalence from 6.1% to 5.9% during the past year, the country's HIV/AIDS control efforts could be undermined by delays in funding disbursement and other challenges, the Lancet reports.

The Global Fund To Fight AIDS, Tuberculosis and Malaria in November 2006 released $70 million in grants to the Kenyan government, which some faith-based organizations said failed to account for previous Global Fund grants. The Global Fund had given Kenya a deadline by which the country had to provide records of how it had spent two rounds of Global Fund money. Faith-based organizations say that government delays in providing audited accounts could cause Kenya to lose millions of dollars in funding. In addition, only 90,000 of the 263,000 people who need antiretroviral drugs have access to them, according to Alloys Orago, acting director of the National AIDS Control Council. The National Community-Based Organization Council said inadequate distribution of antiretrovirals is preventing many people from receiving treatment. Tom Aosa, national chair of the council, called for the development of an efficient supply system, which he said would be particularly helpful at reaching people in rural areas. The stigma surrounding AIDS is preventing some people from obtaining antiretrovirals through official channels for fear that their HIV status might be exposed, the Lancet reports. In addition, health officials have said the growing number of HIV-positive people in Kenya who also have visceral leishmaniasis, or kala-azar, could cause a major health problem. "HIV and kala-azar are a lethal cocktail, and efforts must be taken to control the trend," Koert Ritmeijer, an adviser with Medecins Sans Frontieres, said, adding, "Kala-azar will remain a serious health threat due to the growing number of people infected with the disease as well as HIV" (Wakabi, Lancet, 1/6).

Pediatric HIV in Kenya is a "silent" health problem that is being "overshadowed" by the decreasing number of new HIV cases among adults in the country, the East African Standard/AllAfrica.com reports. There are roughly 150,000 to 180,000 HIV-positive children in Kenya, and about 34,000 new HIV occur cases among children annually, according to the East African Standard/AllAfrica.com. Getting children tested for HIV is a challenge. "Most parents are apprehensive about subjecting their children to HIV tests especially when they are not sure of their status," Renson Mukhwana, chief pediatrician at the Comprehensive Care Clinic at Gertrude's Garden Children's Hospital, said, adding that parents often also decline to have their children start treatment when they are found to be HIV positive. Sometimes parents reject the results of the HIV tests and seek additional tests before accepting that their child is HIV-positive, David Kiptum, a doctor at the clinic, said. Another challenge associated with pediatric HIV cases is that sometimes children who are not told of their status until they are older lose trust in their parents, Kiptum said. Children also face potential stigmatization and discrimination at school, Mukhwana said (Onyango, East African Standard/AllAfrica.com, 1/5).