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Aids complicates poor state of health system



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Although data from the Ministry of Health shows that pneumonia, malaria and cancer are Kenya’s top killer diseases, a great deal of attention has been focused on HIV/Aids, largely because it is a lifestyle disease.

And according to UNAIDS, Kenya has one of the largest HIV epidemic in the world after Swaziland, Lesotho, South Africa, Mozambique and Uganda.

Dr Melsa Lutomia, the county executive of health in Busia said that HIV/Aids has a major detrimental impact on the economy and the society, hence the attention that it has been given.

She dismissed claims that the attention has anything to do with a donor-driven agenda.

“We cannot call it ‘over focus’ because we have not taken our eyes off other diseases such as diarrheal diseases,” she told the Saturday Nation.

Citing her county where HIV prevalence has risen to 7.7 percent from 6.7 percent according to the latest data from National Aids Control Council (Nacc), she said that there is need for more attention on HIV.

Her counterpart from Makueni, Dr Andrew Mulwa, said the country has made huge strides against the other killer diseases — pneumonia, malaria and cancer — due to aggressive campaigns, especially on immunisation in the case of pneumonia.

Makueni, he said, has allocated money aside to HIV and other diseases based on need and severity.

Dr Mulwa, who is also the chair of the caucus of health executives, said that while each county has unique health needs, HIV/Aids is an issue of priority for many counties.

Adding his voice to the debate, Dr Patrick Oyaro, a public health specialist, said that in a situation where resources are scarce “quality and equity is a tricky balance that can be solved by data”.

Both Dr Oyaro and Dr Mulwa, however, expressed their concern over Kenya’s reliance on donor funds. Even though the government doubled its funding to HIV since 2006, about three quarter of the national HIV response was externally funded.

However, in July 2015, Kenya was reclassification as a lower middle-income country, meaning that it will be locked out of donor funds meant for low-income countries.

Already, some donors have stopped funding some of Kenya’s HIV campaigns as evidenced by the $315.27 million deficit on HIV programmes for 2015/2016 financial year.

Dr Edwin Barasa, a health economist from the Kenya Medical Research Institute (Kemri)-Wellcome Trust, said Kenya does not even reach the recommended 15 percent allocation of the national budget to health as stated in the Abuja Declaration.

Dr Barasa, who has studied counties’ health systems, said the devolved units allocate more money to health than does the national government.

However, he questioned how the money is used. “Nearly 80 percent of it goes to human resource (salaries), leaving very little for services,” he told the Saturday Nation.

Dr Barasa noted that most counties are also likely to spend money on hospitals but rarely on dispensaries and community-level preventive medicine.

“It is easier, cheaper and life-saving to teach someone to live healthy and prevent cancer or go for screen than waiting to treat it at the hospital,” he said.