After watching her husband die, woman fears ARV shortage could cost her kidneys

Monicah* watched her husband die from kidney failure after years of living with HIV.

Months after his death, she went to hospital to have her kidneys checked, fearing that she could suffer the same fate.

Tests confirmed she already had mild kidney failure.

“I was told my kidneys were okay, but they were not functioning well. So where was I headed? Failure,” says the Nakuru-based resident.

Monicah, who has been taking antiretroviral drugs (ARVs) for about 30 years, was advised to transition to Tenofovir Alafenamide Lamivudine (TAF LD), a newer formulation considered less harmful to the kidneys, from Tenofovir Disoproxil Fumarate (TDF).

“I did not wait for failure. This is why I was transitioned,” she adds.

Monicah is among hundreds of patients who need to be maintained on a kidney-friendly regimen following concerns over the long-term effects of some HIV medicines.

TAF LD, are ARVs administered to HIV patients with chronic kidney disease, weak bones and those above 60 years.

But now, Monicah fears that disruptions in the supply of TAF LD could leave patients like her exposed to medicines they had been moved away from because of kidney concerns.

The country has reported stock-outs of TAF LD regimens since April.

Stock outs has forcing some patients to receive shorter supplies, while others have reportedly been transitioned back to previous regimens, risking kidney failures and AIDS related deaths.

Monicah, says going back to old ARV regimen is frightening.

“Who do you transition back to a regimen that spoiled your kidneys?” She poses. “I will not hold discussions with anyone telling me about transitioning back. Where are you taking me, to death?”

Fears of being transitioned back to TDF are deeply personal to the HIV/AIDS ambassador.

She takes The Standard back to the ordeal of her husband, Bernard*, who was also living with HIV, and developed kidney failure after years on ARV treatment.

Bernard went to hospital in December 2025 after falling ill and was diagnosed with kidney failure.

He was transitioned to TAF LD regimen, but by then his kidneys had failed, dialysis did not work. He later died.

After Bernard’s death, Monicah enrolled for HIV care in January 2026 and has continued taking her medication.

However, in early July 2026, she went to collect her medication, but was given only a refill of one week.

After depleting her drugs, she has been using stock left by her husband.

“I have been taking ARVs that my husband was using before he died. Now with nothing left, how safe are my kidneys?” says Monicah. 

The shortage is so wanting that some patients, even those with kidney failure are being forced to use old treatment for survival.

Some, are only given medicine to last for one week.

“You are telling someone whose kidneys are transitioning to go where?” she adds.

Monicah’s worry is that years of taking medicines could eventually take a toll on her vital organs, and among older people whose kidney function may already be declining.

“We are living with these drugs for many years,” she says “When you reach 60, you already have challenges with vital organs. You cannot tell someone whose kidneys are already having problems to go back.”

People living with HIV, through their network National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK) are demanding supply of the medicine.

According to NEPHAK, TDF has greatly contributed to kidney failure among people living with HIV.

The Ministry of Health, through the National AIDS and STIs Control Program (NASCOP), introduced TAF LD to avoid chronic kidney disease among people living with HIV.

“The kidney story is really complicated because one of the preferred first-line drugs, TDF is a culprit. That is why TAF LD was included in the guidelines,” said NEPHAK.

Cases of kidney ailments, according to NEPHAK, are high among people living with the viral disease, leading to Advanced HIV (AIDS) deaths.

The association raised concerns about stockouts, demanding supply to avert AIDS related deaths.

Data by the National Syndemic Disease Control Council (NSDCC) shows that about 1.4 million people living with HIV are on treatment.

In 2025, at least 21,007 died of AIDS.

In a letter to NASCOP, NEPHAK said the drugs have been out of stock since April 2026.

“I am sending this letter to follow up on access and availability of TAF LD) that has been in low stocks since April 2026,” reads a section of the letter written by NEPHAK.

The treatment regimen, according to NEPHAK, was introduced by the Ministry of Health and NASCOP as a safer, highly effective alternative to the tradition TDF based regimen and is suited for people living with HIV with long-term kidney damage, bone density and those above 60 years.

In May, NASCOP advised a temporary freeze on the transition to a new ARV regimen because of funding transition and shipment delays.

“We regret that there has never been any follow-up communication and some people living with HIV already initiated on TAF LD are now being forced back to TLD. For those with chronic kidney disease, this is life-threatening," added NEPHAK’s letter.

In the letter, which The Standard has a copy of, NEPHAK demanded to have a meeting with NASCOP to provide clarity and finer advise on the matter.

Contacted by The Standard, head of NASCOP Dr Andrew Mulwa did not respond.

NASCOP promised to have the supply of the ARV regimen by August.

But six months later, the country is still reporting stock-outs.

Individuals in need of the ARVs do not receive them, with hospitals reporting stock-outs.

However, over the weekend, the NASCOP boss is reported to have notified NEPHAK that the ARVs have already arrived in the country.

NASCOP blamed Kenya Medical Supplies Authority (KEMSA) for the delay in distribution of the medicine to users.

Further, NASCOP is reported to have promised to reach out to KEMSA to fast track distribution, acknowledging that distribution has caused a lot of anxiety among consumers.

Additionally, the Head of NASCOP is reported to have directed counties to start putting requests to KEMSA for distribution.

Even with the promise, the network is calling on NASCOP to urgently address the shortage and ensure patients receive adequate supplies of in-date medication.

“The more we wait, the more we risk having individuals developing kidney problems. We are risking deaths,” warned NEPHAK.

“We can only appreciate supply when the medicine is being accessed by those who need it, and not being in KEMSA stores,” added the network.

According to NEPHAK, delay in the supply of the medicine is worrying and it means those ageing with HIV, 60 years and above, and those with bone and kidney problems do not have medicine.

Further, the association warned that the delay is likely to force individuals to go back to TLD, a move that risks health challenges, more so developing of chronic kidney disease.

Additionally, he said it is worrying that no new people are being transitioned to TAFLD during this time, even if they have kidney and bone disease.

Kenya adopted the use of TAF LD, following guidelines by the World Health Organisation (WHO), noting it is highly effective, modern ARV drug.

The drug is a safer, newer version of the older drug TDF

It protects the kidneys and bones much better.

But the treatment has some side effects especially when used for long, as it leads to chronic kidney disease.

"WHO advised that people above 60 years and those with kidney problems should not be given TLD but should be given TAF LD," explains NEPHAK.

Kenya adopted TAF LD in 2024.