Govt, USAID tax row stalls distribution of ARV drugs

Fears continue to mount among Kenyans living with HIV/AIDS following the tug of war between the government of Kenya and that of the United States of America over a consignment delay at the port of Mombasa.

The diplomatic row between the two governments has now seen USAID fail to approve antiretroviral drugs for distribution, leaving the country staring at a shortage crisis.

Just as the Ministry of Health agreed to pay Ksh.45.8 million in taxes for the USAID healthcare donations following Parliamentary approval of the supplementary budget in a bid to unlock the stalemate and cause the clearance of a Ksh.1.2 billion worth of a consignment held at the port of Mombasa since January, so did another issue crop up.

The USAID who had imported the consignment under the HIV/AIDS response through a private company, Chemonics Limited, only agreed to release laboratory materials for distribution and not ARVs medication for over 1.2 million patients who depend on the life-saving medicines.

“If this is a donation and you are asking us to pay taxes, then it is in order you give the donation to the government of Kenya to distribute to the people living with HIV. Pay taxes but give back these drugs to this private company…it also brings up audit issues when we have not seen the consignment then you want us to surrender to a private company yet there are distribution channels in the country,” said Dr. Ruth Laibon Masha, Chief Executive Officer, NACC.

Despite interventions, the USAID has now introduced new demands asking to be requested to supervise the distribution of the commodities and also be involved in the escort process of the commodities to various target points.

The Ministry of Health in response to USAID however stated that all official donations of medical supplies intended for public health use must be consigned to the beneficiary who is the government of Kenya or its relevant institutions.

The consignment had items including those for viral load monitoring, HIV testing, treatment and prevention, laboratory reagents for diagnosis and monitoring of treatment, key antiretroviral medicine tenofovir, lamivudine and dolutegravir (tld), and TB diagnostic and prevention medications.

According to letters in our possession, the challenges arising are due to the consignment being imported outside the existing framework between the ministry and USAID that enable the donations to be exempted from taxes by the National Treasury, as USAID imported the medical commodities using a private U.S. company.

According to various stakeholders involved with matters HIV/AIDS, there is more than meets the eye, as it is not the first time the donor has had issues with matters distribution of the said drugs in the country.

Just in case of any ARV shortage in the recent months as the USAID donation was to sort the country for five months, according to Migori Public Health Chief Officer Pauline Amollo, “we’ll be able to distribute what we have proportionately to make sure that all our patients are adequately covered for this period.”

That means persons living with HIV/AIDS will only get their drug supply for a shorter period compared to when they received supply for almost 6 months at a go.

Approximately 1.5 million Kenyans are living with HIV/AIDS with women registering a high number of infections compared to men. Homa Bay County is in the lead with 18.5% prevalence, followed by Kisumu with 17.3%, Siaya 16.2% and Migori with 11.8%.