For thousands of Kenyans living with HIV, the suspension of U.S. aid has created an urgent crisis, leaving them uncertain about their next supply of life-saving medication. At clinics across the country, patients who once received months’ worth of antiretroviral drugs (ARVs) at a time are now being rationed to just a few weeks’ supply. Meanwhile, millions of doses remain locked away in a warehouse, undelivered due to funding freezes.
Alice Okwirry, a resident of Nairobi, has relied on the same clinic for her HIV medication for years. But since the aid freeze, she has been forced to make more frequent trips to collect smaller refills. Previously receiving a six-month supply, she now gets only a one-month dose. For Okwirry and her 15-year-old daughter, Chichi—who is also HIV-positive—the uncertainty is terrifying. “I was just seeing death now coming,” she said. “I told Chichi: what if you hear the drugs are doomed? She told me: Mom, I’ll be leaning on you.”
The root of the crisis lies in the U.S. government’s decision to freeze foreign aid, which has disrupted the global supply chain for essential medical products. While a waiver was later issued to exempt HIV treatment from the freeze, the bureaucratic hurdles remain daunting. The USAID payment system in Kenya has been severely affected, meaning that contractors responsible for distributing medication to health centers are not receiving funds to carry out their work.
A former USAID official, Mackenzie Knowles-Coursin, noted that while the waiver exists on paper, its implementation is stalled. “Projects are left wondering: ‘How am I going to resume activities if you’re not paying me money?’” he explained. The situation has resulted in a stockpile of over $34 million worth of medical supplies and HIV drugs stranded at a warehouse, operated by the Mission for Essential Drugs and Supplies (MEDS), a Christian charity. Among the stored supplies are an estimated 2.5 million bottles of ARVs, 750,000 HIV test kits, and 500,000 malaria treatments.
The Kenyan government has acknowledged the crisis and pledged to mobilize alternative resources to release the medical supplies. Health Minister Deborah Barasa stated that the government expects to free up the stocks within the next few weeks, estimating that the country currently has about five months’ worth of Dolutegravir—a key HIV drug—and eight months’ worth of Nevirapine, which is commonly used to prevent mother-to-child transmission. However, some patients are already facing extreme shortages, with certain clinics only able to provide one-week refills at a time.
Kenya has one of the highest HIV prevalence rates in the world, with approximately 1.4 million people living with the virus. The U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) supplies around 40% of the country’s HIV-related drugs and medical resources. The financial gaps left by the aid freeze are estimated to be around $80 million, according to a report from Kenya’s council on syndemic diseases.
Legal battles are now underway in the U.S., challenging the decision to cut funding for humanitarian programs. Meanwhile, the Kenyan government is considering allocating emergency funding to address the crisis before finalizing its 2025/26 budget. For now, however, those relying on HIV treatment remain in limbo, anxiously hoping that the needed supplies will reach them before it is too late.
