24TH APRIL 2021. Wherever the truth lies in the ARVs shortage situation in Kenya is something that still remains a mystery, but what everyone knows so far is that the essential commodity is yet to reach its intended recipients, people living with HIV.

Jennifer Gacheru is a clinical officer and the site in charge at Bar Hostess Empowerment and Support programme (BHESP) Roysambu clinic. She has approximately 500 active HIV patients that visit her facility to get life-saving drugs. BHESP as an organization has three different clinics in Nairobi catering for approximately 3,200 HIV positive patients most of whom are sex workers. The last few weeks have been agonizing for Jennifer and her team.

“I know we are quickly running out of stock and professionally we can’t tell the patient that in the next few weeks they will not be getting their drugs, we are playing it cool with the patients hoping that the impasse will be solved sooner or later, said Ms Gacheru. “It would be devastating if it reaches a point of sending patients away, she added.

Daisy Kwala, an adherence counsellor with BHESP confirmed that the drug dosage to patients has reduced tremendously. “We now are giving a maximum of one-month dose, not more than that, because even the monthly consignment that we receive has not arrived for this month, we don’t know what will happen next month” explained Ms Kwala.

Mary Nafula (not her real name) is a sex worker who has been collecting her ARVs drugs from the BHESP clinic in Roysambu for over ten years now. She has been getting 3 to 4 months’ dosage for the longest time but now she is being given a reduced dosage that will only last for 2 weeks, meaning she has to make several visits to the facility, eating on to her time and limited resources.

“Whatever the bone of contention is between US and Kenyan governments or KEMSA and whoever else is concerned is something that people like myself living with HIV would really care less to want to know what is all about, ARVs is all we want, it is a matter of life and death,” narrated Ms Nafula

Kenya is experiencing an acute shortage of antiretroviral drugs or ARVs. USAID, which exports the ARVs, halted supply through the Kenya Medical Supplies Authority (Kemsa). USAID accuses Kemsa of corruption and mismanagement. Kemsa has denied any wrongdoing.

Health facilities are now having to ration out dwindling supplies. Meanwhile, some billion doses of medication with an estimated value of $900,000 are being held at the port of Mombasa.

Stuck at the port, as per shipment documents, are 258,954 packs of Tenofovir, Lamivudine Dolutegravir (TLD), which are the main ARV drugs.

The stalemate between the government and the US over anti-retroviral drugs remains unresolved, whereas the government says that the standoff on the lifesaving drugs had been solved, the US observed it is not aware of any resolution.

Health CS Mutahi Kagwe has told Parliament that they had resolved the tiff and that the USAid had agreed to release the Sh1.2 billion drugs to Kemsa and they were already being distributed to 31 counties.

But a United States Embassy official statement indicates that none of the drugs released was from their consignment.

“It is important to clarify that the medications referred to in parliamentary testimony are actually from another donor—Global Fund—and not from USAID. As the largest contributor to the Global Fund, the US is proud that we can once again help the people of Kenya. The donation from the American people through USAID of medications and medical supplies that were stuck at Mombasa port remain in USAID’s possession until our deliberations conclude,” the US embassy statement read.

The controversial consignment arrived on January 18, after an application for the import permits and approval of import declaration form was submitted on December 16, 2020, and resubmitted on January 5.

it is believed that lack of integrity, transparency, corruption allegations and trust may have cost Kemsa the five-year contract with USAID.

For the last five years, since September 2015, the USAID and Kemsa have had a contract for procurement, warehousing and distribution of donations to Kenya. The contract ended on September 25, 2020.

However, before its lapse, it was extended to December 24, 2020. Prior to the review on whether to extend the contract or not, the USAID requested Kemsa to provide a closeout plan at the expiry of the contractual arrangement in line with their normal procedures of the programme closeout.

With this, the donor US government engaged the services of a third party, a privately owned American firm, Chemonics to procure and import consignments on behalf of USAID.

When the said consignment worth Sh1.2 billion arrived in the country in January, the Kenyan government demanded Sh90 million tax.

The life-saving drugs were held at the port until the said company paid the tax with the government saying that USAID side-stepped a routine system of importing HIV/Aids and tuberculosis drug donations through government channels and instead used a private firm.

Previously, HIV commodities were normally received from Kemsa. Imports through private firms do not qualify for special exemptions and are subject to the normal clearance procedure, which involves inspection at the port by Kebs and imposition of taxes, including the railway development levy.

The Health ministry has since advised the donor to change the listed consignee from the private company to Kenyan government.

The latest Kenya HIV Progress Indicators report states that Kenya is recording 114 infections every day, with the number of new infections reduced from approximately 2.8 per 1,000 people in 2010 to 1.3 per 1,000 in 2020.

The national prevalence of HIV stands at 4.5 per cent, with about 1.5 million people living with the virus.

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