Kenya - FY 2009 Approved Funding by Program Area, Agency and Funding Source

Kenya - FY 2009 Approved Funding by Program Area, Agency and Funding Source

*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.

PEPFAR Kenya has been a leader in the scale-up of voluntary medical male circumcision and prevention with positives. Exciting public-private partnerships are being piloted in Kenya due to exceptional PEPFAR leadership and a highly functional interagency team. Additional funding has been reprogrammed to support voluntary medical male circumcision services, in response to growing demand for this important prevention service. The PMTCT program is extremely strong, reaching almost national scale and supporting testing for 69% of women attending ante-natal clinic.

In preparing a COP with a modest decrease over prior year funding levels, the country team redoubled its performance-based budgeting efforts by conducting rigorous assessments of partner performance, pipelines, and the best strategic fit between USG funding and that of the partner government and other development partners. This rigorous assessment resulted in improved strategic programming including efforts to address results from the groundbreaking 2007 Kenya AIDS Indicator Survey (KAIS), which documented disturbing trends in infection, including higher-than-expected rates among older adults and rural populations as well as continuing disproportionate impact on women and girls.

The PEPFAR prevention portfolio for Kenya includes interventions to improve blood safety, reduce exposure through safer medical injection, expand voluntary male circumcision (MC), and prevent mother-to-child transmission; as well as behavioral/sexual transmission interventions including AB programs, condoms and other prevention activities, and work with injection drug users and other high-risk populations. An increasing number of prevention partners are incorporating alcohol and substance awareness messaging in their comprehensive programs. PEPFAR is working with the Government to support the scale up of MC with a focus in Western Kenya where there are high levels of demand from the approximately 900,000 uncircumcised men between the ages of 10 and 50. An additional exciting new prevention program is the Nairobi pilot of the Partnership for an HIV-Free Generation: a unique and promising network of public-private partnerships linking the core competencies of the private sector with the experience and reach of PEPFAR youth programs.

Kenya has increased its breadth and depth of care programs for people living with HIV/AIDS. For example, with strong U.S. technical and financial support, Kenya continues to provide global leadership in expanding CT. It is anticipated that FY 2009 CT efforts are expected to help five million Kenyans learn their HIV status. Additional Care projects include the initiation of CT, prevention counseling and links to treatment in all OVC programs and the expansion of innovative programs such as the Mwangalizi Project, which recruits and trains HIV-positive adults who are successfully managing their own treatment to be accompagnateurs for children without consistent care managers in their homes. Kenya's care and mitigation efforts also include TB/HIV programs to identify and care for those who are co-infected and community-support and mitigation services to strengthen households affected by AIDS.

Treatment priorities include procurement of generic ARV drugs at over 80% of the value of all purchases, accommodating patients failing first-line therapy by increasing the percentage of drug procurement committed to second-line regimens, and preparing for an expected shift to a tenofovir-based first-line regimen later in 2009. Additional funding has been allocated to support TB and HIV programs in order to improve the reach of critical services to co-infected populations.

The Kenya team has requested 15% of Partnership Framework funds to support activities that (1) represent critical priorities as identified in their Concept Note of September, (2) respond to urgent public health imperatives and to the priorities of the Government of Kenya, and/or (3) buttress the quality of data available to inform quantification of baselines and goals for the eventual Partnership Framework document.

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