Cabinet memo drawn to create emergency procurement of ARVs

The government of Kenya is mulling options for the creation of a sustainable fund for the procurement of HIV/AIDS drugs in the country, following the standoff with the United States Agency for International Development (USAID).

The government could have worked its way in a bid to avert an ARV shortage in the country, but it is still unclear where USAID stands in its commitment to this year’s donation in the HIV/AIDS program after appearing to shift goalposts.

Kenya is still and has always been heavily reliant on billions worth of medical donations for TB, Malaria, HIV, and neglected tropical disease programs.

In matters of HIV/AIDS treatment in the country, three sources of funding are in use: the government of Kenya, through the exchequer; the Global Fund that supplies medicines and health products for HIV, TB and malaria; as well as a Presidential Emergency Plan for AIDS Relief (PEPFAR), which is given to the country as donations through USAID.

USAID had committed Ksh.7.5 billion to purchase commodities and ARVs this year that could sort the country’s stock for 5 months for the over 1.2 million people living with HIV/AIDS. The rest of the months were to be from other sources of funding.

For the last five years, the USAID donations have been supplied through a medical commodity programme, a partnership between USAID and the government of Kenya that lapsed in September 2020 but was extended to April 2021.

Unfortunately, despite that agreement, USAID decided to make the donation through a third party, Chemonics Limited, with a consignment that was to arrive in the country in October 2020 doing so in January 2021.

Kenya has always enjoyed a good partnership with the USAID for over 10 years, however, the recent breach of protocol and failure to communicate by the donor, marked the beginning of the major standoff between Kenya and USAID becoming the first of such magnitude over the years.

Despite all interventions made so far, ARV medication is still stuck at the port of Mombasa.

According to a letter dated March 25, 2021 to the Ministry of Health, USAID writes stating, “ KEMSA, USAID and/or its contractor will jointly follow the delivery vehicles, oversee the offloading of commodities, conduct routine visits” in what has perplexed the ministry.

An investigation report published by Global Fund on March 9, 2021 put the spotlight on Chemonics Limited, the private company used by USAID in the procurement of their latest consignment to Kenya.

Between 2017 and 2019, Chemonics through their sub-contractor Zenith Carex defrauded Global Fund-supported programs of $3 million by systematically inflating invoices for the distribution of health commodities to warehouses and health facilities throughout Nigeria.

At the moment, the country is expecting a consignment on April 18 and another in mid-May to bridge the 5-month gap brought about by USAID.

According to Dr. Ruth Laibon Masha, CEO, NACC: “What we have done is draw a cabinet memo to draw emergency fund for procurement of those drugs…. Because what we are worried about is where we are being forced to change laws for donors, today we change America, tomorrow do we change for French? That is why we have country laws.”

The recent standoff still remains a lesson in matters of donor aid especially in programs that relate to health, as over the years, donor funds have been slashed forcing the country to look for other alternatives to support its citizens.