New health rules throw Kenya’s Aids budget into distress

Kenya must double its spending on the life-saving anti-retroviral drugs for Aids patients in the next 12 months, health agencies said, citing the World Health Organisation’s new guidelines on treatment of the disease that are expected to increase the number of beneficiaries and a shift to more expensive drugs.

The organisation last month announced that it had raised the threshold for commencement of antiretroviral (ARVs) treatment to reduce the burden of opportunistic infections associated with late start.

Aids patients are put on ARVs based on their CD4 count — the white blood cells that protect the human body from disease-causing pathogens such as bacteria and germs.

In Kenya, only those whose counts have dropped to 250 qualify for treatment but WHO now includes those with a tally of 350.

The WHO country representative, Dr David Okello, calls on the government to more than double its HIV/Aids budget with the change of treatment guidelines.

“We have amended the guidelines because early initiation of treatment will combat the rise of opportunistic diseases,” he said.

Tuberculosis (TB) is the leading opportunistic disease that kills more than half of Aids patients.

Kenya has 320,000 patients on ARVs based on the old CD4 cell count threshold, half of whom are beneficiaries of government funded drugs.

The new treatment guidelines mean that more 600,000 patients need to be put on the drugs immediately.

But doctors say the national ARV stocks can only last until February 2010.

Financing Aids treatment in Kenya is also expected to be complicated by the WHO’s other recommendation that Stavudine (d4T), a key ARV drug, which has been a critical component of Aids treatment in Kenya, be withdrawn from the market.

The drug’s long term use, according to WHO, causes irreversible side effects that leaves patients with dire complications.

Kenya is estimated to have 1.4 million Aids patients.

The high toxicity level in Stavudine destroys body fat, especially in the legs, arms and face, causing what would seem like dents, affecting body shape, according to the medical services director Francis Kimani.

The drug is also known to cause a buildup of lactic acid in the blood, which is a by-product of abnormal energy production and nerve damage that leads to numbness or a sharp burning sensation in the feet, legs, or hands.