Kenya Celebrates a Million Reasons in HIV Prevention, Treatment and care

Kenya has adopted Dolutegravir (DTG) an AIDS generic drug, making it the second country in sub-Saharan Africa after Botswana.

This is a major milestone for the country in HIV management in the last 14 years where it has tackled stigma  and now covering it.

For instance, in 2000, Kenya had 120,000 HIV related deaths. In 2016 it was 36,000, with Antiretroviral therapy coverage at 70 percent.

The National Aids and STI Control Program (NASCOP) on Wednesday launched the DTG for people living with HIV.

Dolutegravir (DTG) has been the drug of choice for the last two years for people living with HIV in high-income countries as it has very few side effects, is easier to take than currently used formulations (one small tablet taken daily), and patients are less likely to develop resistance. In 2015, the World Health Organization (WHO) recommended DTG as an alternative first-line regimen for adults and adolescents. But until recently, people living with HIV in countries like Kenya were not able to access DTG

“We are delighted to partner with Unitaid on this innovative project that will no doubt improve the lives of Kenyans living with HIV, build healthcare worker experience, and generate the evidence needed to introduce DTG on a larger scale by early 2018,” said Dr Jackson Kioko, Director of Medical Services at Kenya’s Ministry of Health.

Kenya’s Ministry of Health will initially provide DTG to 27,000 people living with HIV who are unable to tolerate the side effects of efavirenz, the first-line HIV drug currently in use in Kenya. The new drug will be introduced in select health facilities across the country, with the aim of making the drug widely available nationwide later in the year. Numerous phase 3 clinical trials have shown DTG to be superior than all other first line treatments, and in 2016 Kenya included the drug into its antiretroviral therapy (ART) treatment guidelines.

From images of emaciated people on their death beds to HIV-positive mothers giving birth to healthy HIV-negative children; from HIV Voluntary Counselling and Testing centers with a back door for clients to slip out unnoticed to VCT centers in public spaces; from people living with HIV (PLHIV) hiding their status from even their closest relatives to PLHIVs sharing their status in public including on mass media. It has taken the unrelenting efforts of scientists, journalists, policy makers and rights activists to achieve these milestones.

HIV prevalence in the general population reached a peak of 10.5 percentage in 1995-96, after which it declined by about 40 percent to reach approximately 6.7 percent in 2003.

Since then, the epidemic has remained relatively stable, with the prevalence ranging from 6.7 percent in 2003 to 5.6 percent in 2012. The stabilization of the prevalence is largely attributed to the scale up of HIV treatment and care, while the reduction of new infections has been marginal. The major concern is how to significantly reduce infections while scaling up treatment and care.

An estimated 1.6 million people are living with HIV in Kenya. Total new HIV infections are estimated to have declined by about 15 percent in the last five years; from about 116,000 in 2009 to about 98,000 in 2013.

Back in the 80’s and 90’s HIV used to be a death sentence but now it is manageable chronic condition hence the celebration. After having taken many lives, HIV was finally declared a disaster in 1999.  Antiretroviral Therapy started in 2003 and it made a big difference.

As at 2014, new HIV infections are estimated to have stabilized at an average of 89,000 among adults and about 11,000 among children annually. Over 80 percent of the total new infections in the country are among adults with 49 percent among women, 37 percent among men and 21 percent among young women. Children contribute to 11 percent of the new infections.

Notably, Key Populations contribute significantly to the new infections. Sex workers contribute about 14 percent, MSMs 15 percent, People who inject drugs (PWIDs) 3.8 percent, casual heterosexual sex 20 percent and heterosexual sex among people in marriage relationships 44 percent. In terms of regional variations, 65 percent of the infections occur in 9 of the 47 counties in the country. The HIV epidemic in Kenya shows a pattern of stabilization of infections at a high level thus presenting a challenge to reversing it.

Back in 2000 there were over 120,000 HIV related deaths in Kenya annually but that is no longer the case as the number has since dropped to 36,000 in 2016 due to treatment. Progress has and is still being made with HIV prevalence dropping 2 percentage points in the last 5 years and new infections among children almost halved.

Read: Kenyan Cancer Patients Set to Access Cheaper Drugs 

In Kenya, approximately 1.5 million people are living with HIV, and just over one million are currently on ARVs.

Unitaid is investing US$ 67 million to address this pressing need in an effort to avoid delays of more than 10 years before new drugs can be introduced in low- and middle-income countries. This catalytic intervention also provides a key opportunity to test DTG’s use in routine treatment for the first time and prepare national distribution channels.

Due to the treatment available, Kenya is on track to eliminate new infections among children by 2021.