The sight of the tiny, mud-walled shelter located in a slum just outside of Nairobi was heart-breaking.
Heaps of clothes, shoes, papers — and a sack of potatoes — were stashed in different corners of the one-roomed dwelling. The picture became still more disturbing when I spotted a figure at the far side of the room panting, and sometimes groaning with pain.
This is Muthoni Njeri, a woman in her thirties who is living with HIV/Aids. She lay helplessly on a tin-supported bed, her eyes fixed on the rusted iron roofing above that looked as if it might fall in at any time. Members of the Maarifa Women’s Project, who were visiting Njeri and other Aids sufferers, could not hold back their tears.
“I have nothing to eat; I have no medicine to make me feel better. I have no financial support because I’m not working, and neither is my daughter. I have nothing except to wait for death,” said Njeri, who was diagnosed with Aids two years ago.
“But, at least my daughter takes care of me. She washes me and cleans my wounds,” she said, displaying a frail arm, patched with sores.
For Carol Olwana — also HIV-positive — the situation is quite different. She is currently taking anti-Aids drugs, also known as anti-retrovirals or ARVs. Olwana looks healthy, and acknowledges that her life has improved greatly since she started the treatment in April this year.
“Before being put on this therapy, my CD4 count was 44 and my weight was 42kg. I was bed-ridden, and prone to opportunistic infections. I got continuous bouts of acute pneumonia, and people [thought] I would not live to see the next day,” she said.
A person’s CD4 count refers to the number of so-called “helper cells” that they have in their blood. A CD4 cell count helps doctors to assess someone’s level of immunity. Under normal circumstances, the count is between 400 and 1 500 per cubic millimetre of blood.
“I started regaining my health within two weeks of being put on ARVs. From that time, I have never fallen sick. My CD4 count has risen to 250 and my weight is now 53kg,” says Olwana, who chairs an NGO called Campaigners for an Aids-Free Society.
She gets free ARVs from the Belgian branch of Médécins sans Frontières, which will supply her with the life-prolonging drugs for the next five years. Thanks to this programme, Olwana is part of a tiny minority in Kenya who have access to the medicines.
The scenarios of these two women bring to the fore the quagmire that Kenya finds itself in as it struggles to contain the HIV/Aids pandemic ravaging the country.
According to the National Aids and Sexually Transmitted Diseases Control Programme (Nascop), about 270 000 people urgently require ARV treatment.
But, at most, only 11 000 Kenyans are receiving the drugs — 6 000 of whom are on government programmes. The United Nations Joint Programme on HIV/Aids estimates that more than two million people in the country are HIV-positive, out of a population of about 30-million.
The government recently announced plans to distribute ARVs free of charge in all its health facilities — about 3 400 hospitals and clinics across the country. It is relying on the Global Fund to Fight Aids, Tuberculosis and Malaria to provide the backing for this ambitious programme, which is intended to supply ARVs to every Kenyan that needs them.
Concerns are being expressed, however, about whether the Global Fund is itself receiving enough money from donor countries. Aidspan, an NGO based in the United States, believes that about $5-billion will need to have been pledged by the end of next year if the fund is to meet expectations. To date, only half that amount has been provided. The fund has been in existence since January 2002.
If it has any fears on this score, the Kenyan government is not admitting to them.
“The money will come, I have no doubt,” says Kenneth Chebet, director of Nascop. “If something happens and it fails to arrive, the government will put in other resources,” he added, without explaining further.
But, President Mwai Kibaki inherited a declining economy when he took power at the end of last year. According to the World Bank, the country’s annual growth rate fell from 6,5% between the 1960s and the 1970s, to just more than 2% in 1990 to 2001. Domestic investment has also declined significantly in the last decade. In the early 1990s, it was put at 20% — but in 2001 had fallen to about 13%.
With statistics from the Ministry of Health indicating that about 700 people are dying each day from Aids-related ailments, health activists have launched campaigns calling for pharmaceutical companies to lower the prices of ARVs.
The government has already achieved some success in this regard.
According to Richard Abura, spokesperson for the ministry, the drugs now cost $19 a month — rather than the $897 that they cost a year ago. This dramatic fall in prices means little to the average Kenyan, however.
The 2003 UN Human Development Report estimates that 23% of people in the country live below the poverty line of a dollar a day.
Aids activists further contend that the costs of the tests necessary for the drugs to be administered are also exorbitant for the average Kenyan. These include tests to establish CD4 counts.
“Each of these tests costs $128 and they are all very necessary before one is put on ARV treatment. They are important because it is from them that the doctor is able to tell which combination of drugs one’s body will require,” says Olwana.
“The question is: how many Kenyans can afford this amount of money?” she asks.
The urgent need to expand access to ARVs was highlighted recently when the World Health Organisation reiterated its commitment to make the drugs accessible to all people in developing countries who are living with Aids. In September, it declared the failure to provide these medicines a global health emergency.
Statistics from the World Health Organisation indicate that about six million people in developing countries require ARVs, but that fewer than 300 000 are being treated. In sub-Saharan Africa, where the pandemic is most acute, only 50 000 people are accessing the drugs. About 30-million Africans are HIV-positive.
For another Aids sufferer in Kenya, Malda Atieno, every day that passes without significant progress on his matter, is a trial.
While Carol Olwana speaks excitedly about the positive effect that her improved health has had on her children, Atieno describes a life dogged by exhaustion: “My body has been deteriorating day by day. I’m always feeling sick, and [I’m in] bed all the time. I cannot do anything constructive, because I’m always tired.”
“How I long for anything that can reawaken my body,” she says. — IPS