What happens when donors bid farewell?

  

"ARVs are now free in most health facilities!" That was too good to be true. Many people had died poor after selling all their property to buy anti-retroviral drugs (ARVs) Kenyans would cross the border to the neighboring country, Uganda, where there was medicine albeit at a very high price. What news would then have been more welcome than the announcement that the medicine was now free and available in most health facilities in Kenya! There was also a nutrition pack available which the local community had christened 'care' and there was free civic education on HIV.

But recently, the National Empowerment of People Living with HIV/AIDS in Kenya (NEPHAK) revealed rather disturbing news: there is an acute ARV shortage in Kenyan health facilities. The news was as frightening to patients as the first time they knew their HIV sero- positive status. In an effort to enhance treatment adherence, health providers had pointed out the repercussions of skipping the medication or failing to take the medicine at its right time. The consequences included drug resistance and subsequent death. With that in mind, the ARV beneficaries were required to get a guarantor to ensure that they never defaulted. They followed the prescription to the letter principally out of fear of the repercussions.

 The civil society group, led by NEPHAK's head, Nelson Otuoma, held a demonstration last week to protest at what they called the government's denial of the ARV situation in Kenya. To resolve this the protesters asked the government to create a trust fund for HIV treatment, should funds from donors dry up.
Agreeing with Otuoma completely, what this group was asking for is something that should have been done the moment HIV was declared a national disaster. But the notion put forward by the government was that HIV treatment was free. I am fully convinced that this service was not free but someone, a body or an organisation was meeting the staggering bills. ARVs are an expensive type of medication. In this case 'paid for' would be a more appropriate word than 'free.'

This situation reminds me of a folk tale where a fox and a man were partners in a farm. The man would dig and plant while the fox was tasked with chasing away the birds and other animals as the crops grew. After every harvest, the farmer would spare some grain to plant in the next season while the fox cleared his granary, so sure that man would plant. Come one season the man got wiser and declared an immediate termination of the partnership, and the fox died of starvation (maybe a few foxes demonstrated in protest).

Like the fox, Kenya perhaps relaxed and was sure that the donor would provide so no emergency measures were taken for the day the giver may not arrive. There are many HIV and TB related organizations that are donor-funded in Kenya today. My wish would be that they learn from this threat and start laying strategies on life after the donor. The ARV situation in Kenya is not a laughing matter, so many lives are threatened! Scrapping off the lessons of adherence seminars from those who have received them may require serious civic education. To tell someone they can live without ARVs after the stern caution that skipping a day may be suicidal will not be easy.

I would suggest that we be ready for the day when we need to be self reliant. Kenya does not need to be under duress from demonstrators to meet their own responsibilities! Exit the donor, enter the government of Kenya to save its population from mass deaths. Someone should help Kenya in management: Kenya is a resourceful country, we can't watch people die in their thousands because the donor has left. People living with HIV (PLHIV) should also start farming and supplementing what the HIV nutrition package offered.
Let us all be ready, when the proverbial goose that lays the golden egg dies, we must continue fending for ourselves and save a population. The next generation should not find a country demonstrating because the donor has left but a country well sustained and able to protect the pride of its population.