Fight against HIV, TB boosted with $27m grant

Saturday July 20 2013

By JEFF OTIENO The EastAfrican

Kenya’s war against HIV and tuberculosis has received a shot in the arm after two international bodies extended a $27.4 million grant.

The funding made by the Global Fund and the United Nations Programme on HIV/Aids (UNAIDS) follows the country’s successful application for help in combating tuberculosis.

It will have two principal recipients in an arrangement called dual track financing. Ministry of Finance will receive $16.8 million and Amref as principal recipient for non state actors, will get $10.6 million.

The grant will support programmes that improve the quality of diagnosis and treatment of tuberculosis, reduce diagnostic delays in vulnerable population and provide nutritional support to TB patients.

It will also cover TB/HIV co-infected patients and particularly vulnerable population, including prisoners, people living in informal settlements and mobile population.

According to the agreement, the National Treasury will receive funds on behalf of the government and will work with the Ministry of Health’s Division of Leprosy, TB and Lung diseases (DLTLD) as the sub-recipient. They will account directly to Global Fund.

Amref, on the other hand, will sign a direct implementation agreement with Global Fund for the civil society organisations component of the grant.

According to Dr Lennie Kyomuhangi, Amref Kenya Country Director, the organisation will disburse funds to selected civil society organisations — the sub-recipients who will do the direct implementation.

“The recent grant signed by Amref with Global Fund is phase two of the Global Fund TB round nine grant. Phase one run from 1st July 2013 — 31st December 2015 and the project received an A1 rating in project implementation for Phase one,” said Ms Kyomuhangi.

“We can be most effective when all partners are moving in the same direction. In Kenya, and in other countries, the most effective prevention often comes by reaching those most vulnerable to infection,” said Mark Dybul, executive director of the Global Fund.

The project, Ms Kyomuhangi said, will be implemented countrywide with focus on people living in slums, arid areas and other congregate settings like prisons.

“These are the areas where TB prevalence is particularly high due to poverty, congestion and other predisposing factors,” she added.

Cases of multi-drug resistant tuberculosis in East Africa has been on the rise, with scientists expressing fear that the region is at risk of seeing the disease running out of control.

The snail-pace economic growth and the tattered social safety net have connived to give the once-tamed bacteria a new lease of life in the region.

Kenya, for example, is ranked 15th among the 22 high-burden TB countries in the world. Since 1990, the absolute number of TB cases notified has increased ten-fold.

In addition, the notification rates for all cases in Kenya has increased from below 50 per 100 000 in 1990 to 329 per 100 000 people in 2008.

In Kenya, tuberculosis remains a major public health problem while Uganda has an annual incidence of 330 cases of all forms and 136 new smear positive cases per 100,000 people per year. The country is ranked 16th among the 22 high-burden TB countries in the world.

Tanzania is no better. The country records an average of 295 smear positive cases per 100,000 adult population, compared with 261, which was projected by the World Health Organisation (WHO).

In all the East African countries, studies done by WHO reveal, HIV epidemic is still the most significant driver of the increase in the TB burden.

Globally, the disease kills one person every 18 seconds and given the fact that HIV activates dormant TB infection, tuberculosis has become the leading cause of Aids-related deaths in the developing world.

In Kenya and other countries in sub-Saharan Africa, TB vaccine is not effective; some diagnostic tests have been found to fail to identify cases, and many patients, due to various reasons, often fail to complete the six-month treatment regimen.

“If all people in Kenya, for example, can access essential health services with dignity and without fear — then surely this country can tip the balance of the epidemic in Africa,” said Michel Sidibe, executive director of UNAIDS.

Mr Sidibe added that Kenya can have a profound effect on Aids response if it continues to lead in a people-centred approach to health.

In the current financial year, the government allocated Sh34.7 billion ($408 million) against the required Ksh160 billion ($1.9 billion) with the bulk of money allocated going to the recurrent budget and less for prevention and cure programmes.

“To effectively tackle the challenge the government is trying to establish a trust fund to  complement donor support in the fight against the three diseases and a Cabinet paper on its establishment is being finalised,” said Deputy President William Ruto.

Mr Ruto added that the government was considering establishing local plants to manufacture HIV/Aids drugs in collaboration with other East African countries to benefit on the economies of scale.