When Finance minister Uhuru Kenyatta reads the Budget today, Health sector players will be keen to see what allocation he gives towards child health and if any money will be allocated to HIV/Aids among children.
Health experts say the field has largely been ignored in the past, thanks to high costs of diagnosing and treating HIV in children. “Diagnosing HIV/Aids in children is a topic that has not been well addressed due to the high costs it attracts. Children’s medicines are more expensive than those for adults,” said National Aids Control Council deputy director Sobbie Mulindi.
In Kenya, 22,000 new cases of HIV/Aids among children are reported annually. The figure does not represent the total number of paediatric HIV/Aids cases as not all children are diagnosed and the results documented at health facilities.
Cases of children being orphaned at early ages have been cited as the main reason that accounts for the undocumented incidents as most are never presented for diagnosis at health facilities. According to Dr Mulindi, lack of information on the prevalence of HIV/Aids among children has led to poor planning for paediatric programmes.
Statistics show that about 117,000 Kenyan children are infected with the virus. However, only 46,000 children access ARVs even while it is mandatory for all HIV positive children to receive the treatment.
“Children do not have fully developed immune systems. All those infected with HIV should be put under anti-retroviral therapy (ART), but we have never achieved this,” said Mr James Kamau, the coordinator of Kenya Treatment Access Movement (KETAM).
Issues to do with HIV/Aids have made headlines locally for negative reasons like inadequate government commitment to funding programmes.
Budgetary allocation towards HIV/Aids has been wanting, often below 25 per cent of requirements.
Donors carter for the bulk of funding through organisations such as PEPFAR, the Global Fund, and the World Bank.
Due to limited government funding of the fight against the pandemic and lack of an HIV/Aids programme specifically for children, sick children have often ended up forgotten when it comes to funding as other needy cases take top priority.
For example, Sh900 million was set aside to buy anti-retroviral drugs in this year’s health budget but only a paltry share of the amount went to paediatric cases.
“When we talk about increasing budgetary allocation to health programmes, we should also say that such funds need to be specified as to what they are intended to achieve. Maternal and child health programmes have not been given fair sharing,” said Mr Kamau. In addition to inadequate funding, the fact that very few health workers specialise in child health is also a challenge to the war on paediatric HIV/Aids.
While a wide range of health workers can diagnose HIV/Aids in children, follow up on treatment is a speciality of paediatricians.
Kenya is among countries with the lowest number of paediatricians in the world, 250 professionals serve a population of 20 million people under 15 years of age.
Out of these, 170 live in Nairobi, further posing a big challenge to monitoring and managing HIV/Aids treatment among children in rural areas. “It is true that children, especially in rural areas, are not getting enough services from paediatricians as regards HIV treatment and this is also true for other conditions,” said Dr John Wachira, a consultant paediatrician at Getrude’s Children’s Hospital in Nairobi.
Dr Wachira said several factors such as few admission slots for paediatricians in local medical institutions and brain drain account for the problem.
Inadequate personnel has also led to only a handful of health institutions offering infant diagnosis of HIV/Aids. Only 1,000 of the country’s health facilities offer this service.
Mother to child transmission of HIV is the leading mode of passing on the virus to children. While campaigns to scale this down are said to be bearing positive outcomes, their full potential has not been achieved as currently more than half of pregnant women in Kenya do not practice safe motherhood.
Save for 42 per cent of women who deliver in health facilities under the assistance of skilled medical personnel, the rest seek unqualified delivery assistance posing risk of transmitting the virus to new born babies as no medical tests are carried out during such deliveries.
The fact that only half of Kenya’s health facilities offer prevention of mother to child transmission of HIV/Aids services, coupled with the low number of health facilities available for delivery, is an indication that fresh plans need to be drawn to win the war on HIV/Aids in children.