Last Sunday Kenya joined the global community to mark the World Aids Day.
As is always the commemoration provided an opportunity for the country to take stock of progress made in the fight against a disease that was once considered a 'nightmare.'
In the mid 90s, the prevalence (percentage of people living with HIV) was estimated to be about 10 percent with over 300,000 new infections annually among adults.
Stories were told of 'ghost' villages with only the elderly and orphaned children left behind. Most homesteads in worst hit areas were dotted with fresh graves of young people in their productive years who had been wiped away by the virus.
Everyone feared the disease. People whispered in low tones about it, for fear that talking about the HIV loudly, would invite the disease into their homes.
Scientists were equally puzzled by the disease, which was claiming lives much faster than the pace it was taking to understand the virus and find solutions to curb it. The situation seemed hopeless.
But 20 years down the line, a lot has changed — for better — in the HIV arena globally. In Kenya, the prevalence is now down to 4.7 percent, with the number of new annual infections reducing to less than 50, 000. Aids-related deaths have also been on a downward trend, falling from 60,000 in 2014 to 28,000 in 2019.
People are now living longer and healthy lives with the disease, thanks to behavioural changes and breakthroughs in the management of the disease.
As this happens, Kenya is once again staring at the looming cancer crises.
Recently, during the Cancer Awareness Month in October, media were awash with gloomy stories that portrayed the havoc that the disease is causing in communities.
The statistics are still frightening. Approximately 47, 887 people get the disease annually while 32,987 die from it. For many people, cancer has become the 'monster' that HIV was. And many view it as a death sentence.
As Kenya comes to terms with the cancer challenge, experts note that there is a lot to draw from the HIV success story to help in the fight against cancer.
Addressing a health problem starts with the realisation that a particular disease is an issue, followed by a commitment to tackle it with all means possible.
This happened when HIV/Aids was declared a national disaster in 1998. It led to the creation of the National Aids and Sexually Transmitted Infections Control Programme (NASCOP). This special unit was well funded to co-ordinate efforts aimed at reducing the burden of HIV.
Inasmuch as cancer is recognised as a disease of major concern to the country, health experts note that it is yet to receive the same attention.
The National Cancer Institute, mandated to oversee all activities concerning the disease, struggles with insufficient funding and inadequate staff.
Professor Lawrence Banks, the Director General for the International Centre for Genetic Engineering and Biotechnology (ICGEB), who has done extensive research on cancer, notes that public awareness for disease prevention was instrumental in the fight against HIV. And can also play a significant role in cancer control.
The numerous resources channelled towards advocacy initiatives, from both the public and non-governmental organisations, enabled many Kenyans to become knowledgeable about the disease- how it spreads and ways of averting infection or managing the condition once someone is infected.
The messages were reaching people of all ages — in both rural and urban areas — including school pupils that had HIV clubs in their learning institutions.
Mr David Makumi, Chairman of the Kenya Network of Cancer Organisations says that much more resources are required for awareness about cancer, its symptoms and risk factors such as obesity, smoking and high alcohol intake.
"Screening for cancer and early diagnosis saves life. But not many people know that. So, we still have many people coming to hospital when the disease is already at advanced stages. With awareness, this can change."
Aside from disease prevention, health experts note that enhanced public awareness also helps to put pressure on governments, international bodies and other stakeholders to pay attention to health challenges.
This was useful in the HIV fight. And has also been instrumental in pushing for reforms in cancer care.
Professor Banks notes that sustained awareness creation, eventually creates a demand in services that need to be availed for disease control efforts to be effective.
In HIV care, for instance, people are more receptive to calls for early diagnosis and treatment because the infrastructure and systems supporting these initiatives have been strengthened.
For example, HIV testing is free of charge and within easy reach for people in both rural and urban areas.
Upon getting their results, those who test positive are also assured of proper treatment — at no cost — through the use of Antiretroviral drugs (ARVs).
In addition, there are many programmes offering psychosocial (counselling) and nutrition support for those affected.
When it comes to cancer, the scenario is totally different. Prevention messages urge Kenyans to go for early check-ups yet the National Health Insurance Fund (NHIF) does not support preventive screening for seemingly healthy populations.
It only meets costs for screening procedures (like pap smears and mammograms) if the tests are recommended for treatment or diagnostic purposes by doctors.
"By the time people feel sick and go to hospital, it may already be too late. So, the focus should be on reaching the healthy population before they become sick," notes Mr Makumi.
With regards to treatment, the NHIF has a limit on the amount given for treatment, which varies from one person to another. As such, families are usually forced to dig deep into their pockets or fundraise so as to supplement what they get.
"We see people still asking for millions when they have a cancer patient because NHIF money isn't enough. This is scary and it makes people shy away from tests out of fear of the suffering they imagine they will go through when diagnosed with cancer," says Maureen Njoki, a banker who has participated in numerous cancer fundraising events.