Uncertainty threatens Africa's HIV patients following USAID freeze

Topista Nabwire, a 48-year-old teacher in Nairobi, Kenya, and her teenage daughter Gladys Naliaka have been managing their HIV/AIDS condition using antiretroviral medication for years, but now she fears they may have to stop using the drugs shortly.

Nabwire, who contracted HIV 24 years ago, said that she used to receive six-month supplies of antiretroviral medication from her local clinic, but now she and her daughter can only get a month's supply at a time. This follows a 90-day foreign aid freeze ordered by United States President Donald Trump after he took office in January. In her case, the medicine is delivered through USAID's President's Emergency Plan for AIDS Relief, or PEPFAR, which supplies almost 40 percent of Kenya's HIV drugs and supplies.

"I am afraid the supply of the drugs might finally stop completely," Nabwire said.

Nabwire, who also doubles up as a chairwoman for a local HIV/AIDS support group in Nairobi, said the sudden stop of USAID funding in support of PEPFAR would have a devastating effect on thousands of patients in the country like her if they are required to procure the drugs with their own money.

Nelson Otwoma, head of the National Empowerment Network of People Living with HIV/AIDS in Kenya, said some lifesaving health projects that had their funding contracts abruptly suspended such as malaria, HIV/AIDS and tuberculosis, have received letters reversing that decision from the US government, but their work remains in limbo since funding for the projects has not yet restarted.

Otwoma noted that with over 70 percent of Kenya's HIV/AIDS, tuberculosis and malaria treatment programs reliant on international donors, especially the US, the directive to freeze aid is expected to have an overwhelming consequence on access to essential medicines and public health interventions.

"Kenya had made progress in the fight against HIV/AIDS but the current stockout of antiretroviral medication following the announced suspension, has left patients facing treatment interruptions leading to increased viral resistance, treatment failure and potential increase in new infections," Otwoma said.

Jeffrey Okoro, executive director of public health nongovernmental organization CFK Africa, said while some HIV/AIDS treatments have resumed, the future of these services is still uncertain.

"Currently, there is a prevalent sense of fear among patients when it comes to losing access to critical healthcare services and livelihoods lost. Unfortunately, even programs that were not directly supported by USAID have been affected as it disrupted the supply chain of medications in Kenya," Okoro said.

He added that as public health professionals, they are worried that this could lead to a resurgence of HIV/AIDS, undoing decades of progress against the disease. With over 1.4 million people in Kenya depending on PEPFAR's facilitation of lifesaving care and treatment especially in poverty-stricken communities, Okoro said that they are doing what they can to mitigate the losses.