People living with HIVAIDs demand SHA coverage, threaten countrywide protests

People Living with HIV/AIDS (PLHIV) are now demanding to be included in the Social Health Authority (SHA) coverage.

The PLHIVs under National Empowerment Network of People Living with HIV/AIDS in Kenya (NEPHAK) also want clarity on user fees while going to pick Antiretrovirals (ARVs) drugs at health centres.

The demand comes after the recent move by United States of America's President Donald Trump in August cut funding to U.S. President's Emergency Plan for AIDS Relief (PEPFAR).

The group presented a petition to National AIDS and STI Control Program (NASCOP) (Kenya) offices situated within Kenyatta National Hospital.

They then held a peaceful protest walk to present the same to National Syndemic Disease Control Council (NSDCC) located at Kenya National Library Services(KNLS) building in Upper Hill.

The walk ended at the Ministry of Health (MoH) offices, where they also presented the petition to Stephen Kiptoo, director of administration.

“We, the people living with, at risk of and affected with HIV and related co-infections, including Tuberculosis and related comorbidities having noticed the deteriorating quality of HIV services in the past few months, do hereby issue this letter to NASCOP, calling for the sustained improvement of quality of HIV care even in the face of integrated people centred health services," said Patricia Asero, chief executive officer of Ringa Women.

They asked NASCOP to follow up and act by ensuring quality of HIV care, saying PLHIV deserve the quality of HIV care as outlined in the Guidelines on ‘Minimum Package of Care’, (as defined by the MoH under the Kenya Essential Package for Health (KEPH)) including quality laboratory services and not just the issuance of ARVs.

On user fees, the group demands clarity whether it is the official policy of the Kenya government to charge PLHIV when seeking care, and if so, they called for a waiver for the most vulnerable recipients of care. 

The PLHIVs also want NASCOP to train and sensitise health care workers, including Community Health Promoters (CHPs) on privacy and confidentiality and on screening for HIV co-infections and comorbidities, including other non-communicable diseases.

They also want it to engage PLHIV as mentor mothers, adherence counselors and peer educators to support peers through care.

Thegroup also want NASCOP to work on the intermittent stock-out of laboratory and diagnostic services that include HIV testing (kits and reagents), viral load (PPT Tubes), CD4 cell count machines.

“And for TB, we want you to partner with the National TB Program to make sure molecular technology and loop-mediated isothermal amplification services to be available at the labs across the country. Make lab tests and diagnostics free for PLHIV as part of care (creatinine, liver function test, drug resistance testing),” said Ms Asero.

She added: “Importantly and urgently, provide documentation on the numbers of PLHIV and needs (HIV minimum package of care) for consideration by Social Health Authority (SHA) coverage. The documentation should be shared with NEPHAK for follow up advocacy and communications.”

Nelson Otuoma, executive director of NEPHAK said despite there being ARVs, other things that goes with it like lab testing are not there.

“Before ARVs, one need s to be tested in a lab for CD4, viral load, creatinine for the kidney, liver function test. These days because there is no money from Global Fund and PEPFAR, those who go for ARVs are told to go for tests in private labs yet these PLHIV has no money,” said Otuoma.

He added: "Also, most of these facilities, since there is no donor funding, some are told to pay between Sh500 to Sh2,000 to get ARVs. We don’t want to fight with facilities. Can the MoH provide a waiver for user fees so that people are given medicines? Also, can these tests be covered by SHA because we feel that the more SHA is excluding PLHIV amounts to stigmatisation

Otuoma said if the Ministry of Health does not act on their demands within two weeks, they will mobilise a countrywide protest of PLHIVs.

Ms Asero also raised concern over maternity care, saying a requirement that a mother has to register a child after birth within six hours, is sometimes not possible, thus exposing the born baby to mother to child transmission (MTCT).

“One aspect that we are now worried about is the care that mothers are receiving in the maternity. Because we are told if you don’t register a child within six hours, that child is not treated under SHA coverage,” said Ms Asero.

“Initially, any child under five years was treated for free. But right now we understand now everyone has to pay for SHA whether it’s a child or infant. For instance, if a child is born prematurely in a hospital like Mbagathi, then you will have to pay and when the child is in the nursery or Intensive Care Unit(ICU), it will cost Sh7,500. For a single woman from Kibera, who has been washing clothes for a living, where will she get that amount?” she posed.