Kenya: New Research Shows Urgent Need to Remove Barriers to HIV Prevention and Treatment in Kenya

Frontline Aids
Domestic financing for HIV prevention and Abuja Declaration targets Our reports show that funding from international donors remains the highest contributor to HIV prevention in Africa, especially for programmes aimed at key population communities, such as men who have sex with men, transgender people, sex workers and people who use and inject drugs. Beyond HIV prevention, governments of all nine African countries analysed in our reports are falling far short of meeting the target to spend 15% of their national budgets on health, as set out within the Abuja Declaration. This reliance on international donors threatens the sustainability of the HIV prevention response, particularly now with international funding for HIV decreasing and a number of donor countries cutting their aid budgets, or reallocating aid to other areas. It also raises questions about each governments’ commitment to ending AIDS as a public health priority.
1 December 2023
Frontline Aids

A new HIV prevention and accountability report developed by Frontline AIDSand community partners, shows that while the Kenyan government have made important progress in reducing the number of people newly acquiring HIV, more investment needs to be made into HIV prevention to meet targets.

Between 2020 and 2022 the number of new HIV infections reported in Kenya have reduced by 20%. And there have been 72% fewer HIV infections reported among children between 2010 and 2022.

Kenya has also recently introduced its eagerly anticipated national HIV Prevention Acceleration Plan, which will guide the nation's trajectory for the next seven years (2023-2030).

But while progress towards HIV prevention in Kenya is moving in the right direction, the report developed by Frontline AIDS and its community partners, including LVCT Health Kenya, has highlighted a number of barriers preventing the country from progressing further. These barriers are slowing progress and reducing the likelihood of Kenya achieving its target to reduce new HIV infections to around 8,000 annually by 2025. These include:

Rising anti-rights movement

The report has highlighted an organized and well-funded anti-rights movement and anti-LGBTQ+ mobilisation in Kenya – which is aggressively pushing for a Family Protection Bill. This will create a more punitive environment for lesbian, gay, bisexual and transgender (LGBTQ+) people as well as derailing efforts to strengthen age-appropriate sexuality education in schools.

There is harmful rhetoric from the anti-rights movement, which is preventing open conversations on key issues related to HIV prevention, intensifying stigma and discrimination towards some key populations and threatening progress made in the delivery of comprehensive sexuality education (CSE) and HIV prevention and sexual and reproductive health services to young people, thus posing a major threat to HIV prevention progress.

In response, the report recommends that key ministries implement a proactive plan to challenge misinformation and tackle anti-rights activism, as well as putting measures in place to halt the approval of the Family Protection Bill.

Slow technology adoption

There are effective tools and approaches available to prevent HIV. This includes the Dapivirine vaginal ring (DVR), which provides women and girls with vital protection from HIV. And an injectable, long-acting form of PrEP, known as Cabotegravir Long-Acting Injectable PrEP (CAB-LA), has been shown to significantly reduce a person's risk of acquiring HIV. However, in Kenya the process of approving CAB-LA is facing significant delays and no one is sure why.

New HIV prevention technologies are essential in the prevention of HIV in Kenya, and so the report calls for the urgent approval of CAB-LA in order to ensure that this technology is available to communities that need it, paving the way for wider rollout of this essential technology in Kenya and across Africa.

Donor financing declines

Kenya currently faces a shortfall of more than US$1.8 billion for its HIV response over the next five years - which raises questions around the sustainability of their response.

In 2023-2024, 11% of the government's total annual budget went to health, falling short of the 15% recommended by the Abuja Declaration.

There is also a decline in donor funding. And yet the country's HIV response continues to remain heavily donor funded at 63.5% in 2021/2022.

As such, the report recommends that Kenya develops and implements a comprehensive Domestic Resource Mobilisation strategy for HIV, including prevention.

Social barriers for young Kenyans 

Adolescents' sexual and reproductive health remains a highly contentious issue in Kenya.

In May 2023, Kenya officially withdrew its support for the Eastern and Southern African Ministerial Commitment on CSE, following a successful misinformation campaign by the anti-rights movement claiming that this would sexualise children and threaten African values. This is disappointing as CSE remains an integral foundational activity for HIV prevention with school going children. The new Reproductive Health Policy (2022-2032) also fails to address young people's sexual and reproductive rights.

The report recommends that there be the urgent development of a clear legal framework for under 18s seeking to access sexual and reproductive health services and an expansion of access to evidence-based, age appropriate CSE for primary and secondary school children.

Patriciah Jeckonia, Program Manager Policy and Partnerships & MOSAIC Project Director, LVCT Health said: "The report completed by Frontline AIDS, LVCT Health and a coalition of local partners highlights the progress Kenya as a nation is making towards HIV prevention and accountability but also acknowledges the shortcomings and where the country can improve in our mission to eradicate HIV.

"It is vital that as a nation we move towards achieving the targets set out within the Abuja Declaration on HIV/AIDS and commit to 15% of government expenditure on healthcare. Improved access to new prevention technologies and a greater willingness to educate the public and youth on HIV prevention will go some way to doing this. However, it is vital that social and legal barriers are removed, such as addressing stigma and discrimination, the decriminalisation of sex work and a more robust programme to report human rights violations."

Prof Nana Poku, Chair of Frontline AIDS said: "Today's landmark report shows that while governments across Africa and in India have made important steps towards reducing the number of people newly acquiring HIV, much more can and needs to be done in the fight against HIV.

"Our reports highlight that all nine of the African countries analysed are presently failing to meet the target of spending 15% of their national budgets on health, as outlined in the 2001 Abuja Declaration. With effective tools and approaches to prevent HIV, including exciting new prevention technologies, it is vital that governments take the requisite steps to stop more people newly acquiring HIV around the world.

Lois Chingandu, Director of External Relations, Frontline AIDS said: "It is important that countries do more when it comes to investing in HIV prevention methods but also show stronger leadership in countering anti-rights narratives within their countries. Well-funded and highly organized movements are promoting anti-gender and anti-LGBTQ+ narratives which have resulted in 7 out of the 10 countries analysed criminalizing people who engage in same-sex sexual acts.

"While progress has been made, barriers to HIV prevention remain. Today's reports highlight the need for further investment to prevent HIV but also the need for much stronger leadership when it comes to countering anti-rights narratives if the global community is to strengthen and progress the HIV response across these nations."

The report acknowledges the importance of the work done by the Ministry of Health and its donors in strengthening Kenya's response to HIV. However, to secure more rapid progress towards achieving its HIV prevention targets, the report urges the Kenyan government to fully implement a new national HIV acceleration plan.

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