Access to treatment
We have around 400,000 people in Kenya on antiretroviral therapy (ART) but not all of those who need it have it because of a myriad of social, economic and stigma related issues attached to being HIV positive.
The socio-economic constrains of the majority of people who need treatment means they are unable to access it and the long distances to service delivery points where people living with HIV can get ART are a major hindrance.
The social and economic costs of accessing ART for many Kenyan families mean it is too expensive, even if the drugs are free. This is largely due to the lack of health facilities offering ART services that families can easily access and some facilities are simply inaccessible because of the underdeveloped road infrastructure. So, where such facilities do exist within reach they are understaffed to serve the people effectively.
Clearly, the current economic crisis is also a worry as it is starting to have an impact on the ability of many people living with HIV to access ARVs.
Attitudes towards the most marginalised
The attitude towards the most marginalised groups of people is another major challenge in Kenya, in particular towards injecting drug users and men who have sex with men (MSM). This makes our job of reaching the most at risk people with HIV prevention, treatment and care very difficult.
The mention of injecting drug users and men who have sex with men in the government’s national AIDS strategic plan 2010-14 gives us a major opportunity to discuss access to services. There is however need to sensitise health workers on the same. The cost of treating drug users is beyond the reach of users with such modest socio-economic backgrounds.
There is a need to deal with the issue of criminalizing men who have sex with men. This issue is very controversial here in Kenya. As people will be aware there has been a wide discussion in the media about gay marriage and homosexuality. I believe this is healthy we need these debates and discussions for people to understand the issues fully. We need to develop champions among Kenyan MPs and Ministers to spearhead these discussions. We need to change.
Women and children
KANCO is involved in numerous forums across the East African community. We look at issues of gender, working with different groups such as female lawyers so they can be equipped to work with women who have been thrown off their property after their husbands die. It’s a real problem here.
We also need to work to ensure that women understand their sexual and reproductive health rights as well as their HIV status. There is need to assist women access microfinance and work against stigma and discrimination in society.
The role of children in Kenya is very important in a range of different ways. For instance, what happens when a parent is sick and needs treatment?
Many children help their parents, read labels on their medicines and take care of them. They play an important family role in ensuring their parents adhere to medication.
What happens now that more children are surviving HIV to become adults? Children need to be agents of change within their communities and within themselves as they represent future generations. They need to work with teachers amongst other duty bearers.
TB and HIV
A lot of work is currently being done around HIV-TB co-infection. There is a lot of advocacy – for instance a campaign for people to open the windows of public transport vehicles to increase fresh air circulation. Increased ventilation will help to prevent the spread of TB. The campaign is advertised in the newspapers and local musicians are playing songs about it.
It’s important for people to be aware and for us to lobby to ensure that HIV and TB services are integrated.
We can use the vast experience that can be found at the Alliance to show us how to work better and bring the best standards to our work. For instance, we have learnt a lot from the work of men who have sex with men in Cambodia. We get help with governance issues and we value the Alliance’s resources and training materials.
In the south, we need friends in the north and from different cultures who can help us see opportunities where we don’t. The Alliance helps us work with people in the best way possible.