Kenya – FY 2010 Approved Funding by Program Area, Agency and Funding Source*
*Only appropriations from the GHCS (State) fund account are notified by the Global AIDS Coordinator.
Consistent with new data, PEPFAR is placing increased emphasis on prevention in FY2010. The PEPFAR prevention portfolio for Kenya includes increased emphasis on HCT efforts in order to increase knowledge of status, rapid scale-up of VMMC, and higher visibility to the implementation of the Partnership for an HIV-Free Generation, a global initiative to link the core competencies of private sector partners with the programmatic experience and reach of traditional partners in youth prevention.
Other prevention activities include medical/technical interventions to improve blood safety and to reduce exposure through safer medical injection, VMMC, and PMTCT. The VMMC program will continue with a focus on responding to very high levels of demand from uncircumcised men between the ages of 10 and 50 in Nyanza Province, with targeted Nairobi communities as a second priority. The funds available for PMTCT will enable PEPFAR-supported sites to provide HCT, including the provision of test results. With PEPFAR support, HIV-positive women will receive a full course of prophylaxis to interrupt vertical transmission, with the majority receiving more efficacious regimens including AZT. Based on a very positive experience with a South Africa-based “mentor mother” program, Kenya is awarding a bilateral agreement through USAID to adapt this program to the Kenyan context, and bring it to national scale as rapidly as possible. Behavioral/sexual transmission interventions include abstinence and be faithful (AB) programs aimed at both youth and adults, condoms and other prevention activities, and work with injecting drug users (IDUs).
With strong PEPFAR support, Kenya’s care and mitigation efforts include: HCT integrally linked to prevention and treatment, as well as TB/HIV programs to identify and care for those who are co-infected; support for OVC; integrated TB/HIV programs for rapid diagnosis of HIV among those with active TB and vice versa, and treatment of TB among those who are HIV-positive; community-support and mitigation services to strengthen households affected by AIDS; and health services for children and adults that complement ART by intervening to prevent and treat opportunistic infections (OIs), prevent transmission of HIV by those who are in care, and/or offering end-of-life care when treatment fails or is unavailable.
Treatment priorities include procurement of generic ARVs 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 in anticipation of phased-out Clinton Health Access Initiative funding, and preparing for an expected shift to a tenofovir-based first line regimen later in 2010. Strengthened support for health systems will be a continuing priority in the continued expansion of ART. Investments in this area prioritize procurement and human resources to expand laboratory services in Kenya, with an increasing number of facilities receiving QA and training for personnel.
PEPFAR signed a Partnership Framework with the Kenyan government in December 2009 focusing on the areas of health sector HIV service delivery; sectoral mainstreaming of HIV/AIDS in prevention, care and treatment, and HSS; community -based HIV programs; and governance and SI. The Partnership Framework documents are now available at: http://www.pepfar.gov/frameworks/kenyapf/index.htm. Additional funding associated with the Partnership Framework will complement and support Kenya’s activity portfolio in the 2010 COP. PMTCT allocations reflect support for many partners to continue outreach activities, as well as the USG commitment to fund 100% of PMTCT drugs. Pediatric care and support allocations are divided among partners who continue to deliver care and support services to pediatric patients. As with PEPFAR Kenya’s FY09 PF allocations, funding is targeted for laboratory strengthening, scale-up of male circumcision and testing and counseling to ensure delivery of the Partnership Framework commitments.
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