With only a quarter of Kenyans who need anti-retroviral drugs (ARVs) receiving them from the government, the race is on to ensure that many more people get treatment to fend off Aids-related diseases.
But, is a similar enthusiasm being applied — particularly by officials — to ensuring that ARV recipients are also provided with enough, good food, without which ARVs cannot work properly?
No, says the Network of African People Living with HIV/Aids (NAP+).
“The government has not been supportive. There is no government initiative that focuses on the issue of nutrition,” says Michael Angaga, national coordinator of NAP+. “Government efforts to address HIV/Aids have focused mainly on provision of ARVs.”
Medina Yahya would probably agree with this claim. A resident of Kibera, the largest slum in the Kenyan capital of Nairobi and possibly Africa, Yahya has developed various ailments, including ulcers, through having taken ARVs on a perpetually empty stomach.
“I was put on the medication at the beginning of last year, and for a long time I was taking it without having any food to eat,” she says.
The 30-year-old has since been advised to go off treatment until her strength improves. But, this depends on Yahya being able to find enough food for herself and her three children. At the moment, she is dependent on hand-outs from well-wishers and the Stara Rescue Centre: an informal school that feeds the children of HIV-positive people, and also provides once-weekly rations to adults living with HIV/Aids.
Thirty-five-year-old Susan Asiko, who provides home-based care to Yahya, tells a similar tale. She has been on ARVs since she was diagnosed with HIV last year.
“At first, the drugs affected me because it was difficult for me to get enough food to eat. I was bed-ridden for a while, but when I started getting food regularly, my health improved,” she says. “Getting food is the main challenge here, especially if one is not working.”
Price of a meal
Kibera houses approximately 700 000 people. More than half of all Kenyans get by on less than $1 a day, according to government statistics.
Ultimately, the price of a meal rather than the cost of ARVs may stand in the way of people with HIV/Aids staying alive.
“What we have experienced here is parents stopping their medication because of the side effects experienced when taking the strong ARVs on empty stomachs,” says Josephine Mumo, the headmistress of Stara Rescue Centre and one of its founders.
“They remain weak and bed-ridden in their houses and unable to fend for their children. They later die, leaving their children as orphans.”
Stara’s attempts to get food from the government have been unsuccessful, added Mumo. The school at present receives supplies from aid agencies.
Non-governmental groups have also stepped into the breach elsewhere. NAP+ has embarked on a pilot project to supply Nutropath, a supplement in powder form, to those living with HIV/Aids. The project is being run in two centres in Nairobi and the western city of Kisumu, and has targeted 150 adults and 50 children.
“The product can be mixed with water, milk or juice, and those who are currently being tested with it have shown tremendous changes in their health,” says Angaga. “Those who had lost weight have regained it. Most of them say they can skip a meal and still feel strong.”
Nutrition budget
For its part, the government insists that the picture concerning nutrition is not as bleak as NAP+ and others claim.
“The government has a budget for supporting nutrition through the Global Fund [to Fight Aids, Tuberculosis and Malaria],” says Patrick Orege, director of the National Aids Control Council — an organisation charged with coordinating the fight against HIV in Kenya.
The fund was created in 2002 as an international partnership to finance efforts to curb HIV/Aids, tuberculosis and malaria.
As welcome as money from the global fund is, the question that begs asking is whether the government should also be committing Kenyan revenue to nutrition programmes for those with HIV — especially in light of its 2001 adoption of the United Nations Declaration of Commitment on HIV/Aids. This document says countries should “increase and prioritise national budgetary allocations for HIV/Aids programmes as required and ensure that adequate allocations are made by all ministries and other relevant stakeholders”.
The theme for World Aids Day this year is Stop Aids. Keep the Promise — adopted in a bid to get governments to uphold pledges made under the UN declaration and elsewhere.
While food programmes may not receive much attention in the national Budget, entertainment allowances for MPs do — not to mention car grants.
Each minister and MP is entitled to a car grant of $44 600, and a monthly entertainment allowance of not less than $1 000. This means that the government spends more than $200 000 a month on entertainment allowances for legislators.
The same amount buys about 17 000 bags of maize, which would doubtless go some way to improving the nutrition of poverty-stricken HIV/Aids patients. At present, 2,2-million of Kenya’s 32,8-million people are infected with HIV/Aids. — IPS