In the chilly morning air, a 10 kilometer walk through the hills of Kisii in Kenya's Nyanza province is not exactly an easy start to the morning, but William Ong'eni is not complaining.
For the father of seven believes his purpose in society is to serve people living with HIV and AIDS - others like himself. Every day at 6 am, Ong'eni leaves his home in Kiamabundu village to go to work at the Oresi health center, some 10 kilometers away.
Ong'eni tested HIV positive in 2008, and like many other cases in rural Kenya when a person reveals their status, friends and relatives shunned him and his family. "Even my first wife left me but I later married again," recalls Ong'eni, who now gives health talks at the Oresi facility.
PEPFAR cuts funding
Ong'eni earns a monthly salary of Ksh. 3,000 (USD 35), a stipend given to volunteers like him through the Tunaweza (Kiswahili for 'we can') treatment and care programme. The programme is funded by Centers for Disease Control (CDC) and the US President's Emergency Plan for AIDS Relief (PEPFAR).
But PEPFAR, one of the biggest donors for HIV programmes in Kenya has been making steep funding cuts, according to recent details reaching the media.
Sources from civil society say PEPFAR had pledged Kenya some USD 460 million for 2014 (about Ksh. 39 billion), but they fear this target may not be achieved. So far the government is not confirming that the US grant is on the wane.
"I am not sure where that notion is coming from that PEPFAR are withdrawing, it's not true. They, plus the Global Fund, continue to be our partners. For example, we have just signed a USD 495 million [about Ksh. 42 billion] deal with the Global Fund for HIV, TB and malaria," said health cabinet secretary James Macharia.
Reduced HIV services
AIDS network KANCO, whose HIV programmes were anchored on PEPFAR, acknowledge that they are sending their employees home.
But, National AIDS Control Council (NACC) insists that the five-year funding pledge by PEPFAR is still on, despite evidence showing that the United States International Development Agency's (USAID) Mission in Kenya received communication from its government to enforce funding cuts from as early as December 2013.
"I am aware that PEPFAR is flat funding, or is not adding more money for HIV programs in Kenya but this will not affect the country much because we still have the Global Fund from which we expect support next year," says Regina Ombam, head of strategy at NACC.
Sources from civil society, including KANCO confirm the recent steep cuts on HIV funding were not anticipated, while American publications say funding for PEPFAR has been falling at a rate of 12 per cent every year since 2010, for all recipient countries.
"In the past weeks, USAID has been applying this guidance and has been communicating to partners about their level of funding cuts, and in some cases, projects were closed," says a document obtained from a source in Kenya who wished to remain anonymous.
Sustainable funding agenda
NACC says there is no cause for panic since the government's sustainable funding agenda which aims to pool resources domestically is in its final stages, and could be tabled to the Cabinet in the next few weeks.
According to Ombam, the fall back strategy has its sights on innovative fundraising options such as establishing an endowment fund and having a reformed national insurance scheme for people living with HIV.
"This is a hybrid model where we are hoping to raise funds through air flights and airtime levies, auctioning unclaimed assets while the government will contribute through the national health budget," says Ombam.
The importance of sustaining HIV programmes on both humanitarian and economic grounds cannot be underestimated. A study by the World Bank in Kenya showed that when AIDS treatment was expanded, adult working hours increased and children's nutritional status and school attendance improved.
Volunteers pay price of cuts
Back in Nyanza province dedicated volunteers from the PEPFAR programme, like Ong'eni, continue to make a significant difference.
"When I am not at Oresi health center I often try to trace people who may be HIV positive, but who may be afraid to share details about their status and convince them to go for voluntary counseling and testing," he says.
He also finds time to make sure that people living with HIV and AIDS from his village in Kiamabundu adhere to medication.
His passion to help people is not limited by the little compensation he gets. However, he may soon find himself jobless.