PREVIEW
Almost 40,000 people working on HIV-AIDS prevention have been put on unpaid leave and free drugs treatment stopped
The follow-on effects of the United States’ foreign aid freeze are set to include patients with HIV/AIDs and tuberculosis in Kenya. Those patients will now have to pay for their drugs under the Kenyan government’s new rules.
Kenya’s new Social Health Authority has classified conditions such as HIV-AIDS and tuberculosis as ‘pandemic’ rather than ‘chronic’. That means that patients with them do not get full health insurance coverage.
The move is a cost-cutting measure which officials say has been driven by US President Donald Trump’s suspension of foreign aid (Dispatches, 28/1/25, Rubio deals hammer blow to US aid) for an initial 90 days but could morph into a permanent shutdown. Kenya received US$850 million in aid from the US, with almost half that amount going to on critical health programmes.
Tens of thousands of Kenyan and foreign aid workers have been put on unpaid leave – pending news from Washington DC. Although the US Trump administration signed a waiver allowing for ‘urgent life-saving HIV treatment services’ under the US President’s Emergency Plan for AIDS Relief, or PEPFAR, to continue, several African countries have had delays with re-starting treatment programmes that had been shut down. About 4,000 workers on HIV-AIDS prevention projects have restarted work but another 35,000 are still on enforced leave.
More broadly, the 90-day freeze on almost all US aid imposed on 20 January by Trump’s executive order has left healthcare systems across Africa trying to bridge vast funding gaps.
Kenya’s Health Principal Secretary Harry Kimtai told the National Assembly in Nairobi at a hearing on 19 February that the government faces losses of Ksh30.9 billion ($220m) for healthcare because of the US aid freeze.
Kenya’s healthcare system was already facing multiple crises after the botched transfer of responsibilities from the now defunct national health insurance fund to the SHA. That had triggered a row between the government and insurance firms on liabilities, leaving thousands of patients out of pocket (AC Vol 65 No 22, Ruto’s impeachment of his Deputy starts to backfire).
The Ministry of Health estimates that 1.3m Kenyans are living with HIV. The ministry has also forecast that if HIV/AIDS drugs are not available for free the infection rate will increase by as much as 60,000 per year, and it could also mean more than 23,000 deaths from TB annually. Most of the victims will have HIV/AIDS.
Kimtai has stated that the government is looking to find alternative donor funding for malaria and TB programmes and will invest in domestic pharmaceutical production, though the latter is a long-term project, and it involves difficult intellectual property negotiations with the leading international drug companies.
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