The dismissal of more than 41,000 health workers previously funded by foreign aid has left thousands of people living with HIV without adequate care. Most of these dismissed employees were frontline workers dedicated to serving HIV and TB patients, providing essential treatment and support.
Following the funding freeze, HIV services have been moved to outpatient units in hospitals under an integration program. Previously, people living with HIV were attended to at Comprehensive Care Clinics (CCC), which provided HIV testing, anti-retroviral drugs (ARV) distribution, viral load testing, and counseling services. These clinics have since closed as Kenya’s Ministry of Health and county governments integrate services into outpatient departments.
The integration of HIV services into the broader health program is meant to streamline healthcare delivery, but it may also lead to increased stigma. There are concerns that patients might experience treatment errors, incorrect ARV prescriptions, and stigma from healthcare workers unfamiliar with HIV treatment. Some new clinicians may also fear handling HIV patients, leading to hesitancy in providing services.
The transition has left many vulnerable individuals without specialized care. The dismissed workers had been extensively trained in HIV care, ensuring effective service delivery, particularly for young people living with HIV. These professionals understood how to reduce stigma and provided care with confidence and expertise.
At least 41,547 Kenyans were employed under the President’s Emergency Plan for AIDS Relief (Pepfar) program. They collectively earned an annual salary of Sh17.4 billion through the HIV program. Their roles included clinical services, community support, and program management across the 47 counties in health facilities at Level 3, 4, 5, and 6.
To mitigate the effects of the funding cuts, the government is expected to allocate an emergency kitty of Sh4 billion to maintain health workers handling HIV services across the country. For the financial year 2024/25, Pepfar’s support for the HIV program is allocated to human resources for health at a total annual cost of Sh17.3 billion.
While integration is meant to be gradual, it must consider the needs of young people and vulnerable groups. Experts warn that without proper handling, HIV-related stigma could lead to treatment interruption. Furthermore, the shift has resulted in additional financial burdens for patients, who are now required to pay consultation fees at outpatient units. Many individuals living with HIV struggle to afford these charges, especially when transport costs are also a challenge.
There is a call for the government to form a single coordinating body for HIV response at the national level, responsible for policy and standards. Counties should collaborate with people living with HIV to develop guidelines on integration, paying particular attention to adolescents, young people, and young mothers.
Previously, HIV services were provided free of charge. Without urgent intervention, the country risks reversing the progress made in the fight against HIV/AIDS. The funding gap arises at a critical time when HIV infections in Kenya have declined by 78 percent. Currently, the country reports 16,752 new HIV infections and 20,489 AIDS-related deaths, a significant reduction since 2010. Urgent measures are necessary to prevent setbacks in the fight against HIV/AIDS and to ensure continued access to quality healthcare for affected individuals.
