Towards Zero: Bold Steps
Those statistics represents People!
While scientists and statisticians get excited by numbers, I wish to remind everyone of us that those numbers represents people! While fighting HIV and AIDS, zero is the only tolerable number. Just imagine that 30 adolescents take a pie in every new 100 HIV infections in a country where about 300 people are infected by HIV daily. I can undisputedly assert that when it becomes to HIV infection, one new infection over hundreds of thousands individuals is significantly greater than zero and every available resource should be injected in averting that infection. I’m from the 7th International Conference on Peer Education, Sexuality, HIV and AIDS that was held as from 15th -17th June, 2016 at Kenyatta International Convention Center Nairobi Kenya. In this conference the mission of accelerating and concerting efforts towards zero with elaborate bold steps was clear.
Her Excellency Mrs Margret Kenyatta who was also the chief guest of the conference alluded that despite the fact that HIV is a single biggest killer of adolescents, Kenya has won many battles including the significant reduction of stigma and discrimination index, medical breakthroughs, prevention of mother to child transmission among others. ‘Fear does not dominate dialogue about HIV’, asserted Mrs Kenyatta. She gave a light of hope when she said, ‘if we solder on we will win this was war. ’ Indeed Dr. Kipruto Chesang from CDC proved that medical breakthrough is real by demonstrating how science has shown HIV self-test kits works. He added its importance by saying that research shows that 70.7% (15-64 years) are willing to do HIV self-test.
During the first plenary session Noerine Kaleeba who was instrumental in founding TASO in Uganda insisted that no one can legislate again sex and sexuality. This drew an attention of fighting HIV and AIDS on behavioral view in country (Kenya) where commercial sex workers are about 200,000 of which 15,000 are men commercial sexual workers as per the presentation that was later made by Victor Ouko on comprehensive social and behavior modification strategies among sex workers in Nyeri County. Yes, men who have sex with men contribute about 15.2% of new HIV infection in Kenya. While APhia Plus Kamili led by Jhpiego Corporation is serving this population, they have seen 93.4% receive HIV Counseling and Testing services with 100% linkages to treatment. Kudos to them!
Dr. Nduku Kilonzo, the director of Kenya National AIDS Control Council (KNACC) made me learn that we are and will still be far from gripping the zero HIV infection if young mothers from the ages of 15 to 24 years continue being newly infected. While Kenya has advanced in the fight of HIV and AIDS, it is not doing well in the domains of young people. This begs the question: what can we do differently? Yes, I thumb up the Maisha Maarifa research hub that has been created by Kenya National AIDS Control Council and several youth friendly services initiative across the country. As a way of example, U-Tena Youth Organization collaborated with like-minded partners to create a youth friendly resource center in Lunga Lunga health center in Nairobi County that serves about 300 youths with sex and reproductive health preventive and curative services on monthly basis.
Evidence shows that treatment has the capacity to avert new HIV infections, reduce HIV related deaths and prevent HIV related illness. Concerted efforts of having HIV free generation by 2030 saw UNAIDS pioneer an ambitious 90~90~90 goals: 90% of people living with HIV to know their status- 90% of people diagnosed with HIV to be enrolled and retained on treatment and 90% viral suppression on all clients on HIV treatment by 2020. Current ART coverage in Kenya is about 51% with a retention rate of about 66% at 36 months and 61% at 60% months. Consequently, many lack accessibility to life saving ART and that is why Juma Mwatsefu made a presentation on how Community health workers lead defaulter tracing of HIV is working Western Kenya. Can this be modeled in other counties?
Ninety percent of all pediatric HIV infections are from mother to child infection! Charles Kabuga who represented Ministry of Health in Laikiapia County illustrated on how mentor mothers program is the cornerstone to PMTCT program in the county. Reducing the rate of mother to child transmission as from 2013 to 2015 by 14.3% TO 8.3% respectively as per the revelation of Dr. Nduku Kilionzo from KNACC indicated that there in hope in reaching beyond zero in the prevention of mother to child transmission if the current efforts are maintained or stepped up!
The conference presenters made me learn that people living with HIV have a 50% lifetime risk of contracting TB. WHO recommends use of Isoniazid for 6 months to prevent TB among all people living with HIV. About 90% of all PLWHIV are on ART but only 5% are on Isoniazid preventive therapy in Kenya. 71.4% were put on IPT by AMREF at Kibera Health Community Health Center on the second half of 2015 as per their presentation during the conference. Now that Kenya is a middle income country, I believe that the budget can be rationalized to put all HIV positive individuals to this therapy. Let’s be bold and take bold steps for health purposes!
Above: Peter Chacha from U-Tena Youth Organization pose for HIV fund advocacy photo during the conference
Nutrition management is a must for HIV and AIDS management! HIV infected person is likely to increase health requirement for about 10% for asymptomatic adults and children. Those who have graduated to AIDS stage will require about 20-30% additional energy requirements to maintain the same body weight whoever children will require more than 50% energy requirements. Fred Muturi from KANCO made a presentation on the lessons learnt from their research and on how they are addressing the issues of nutrition among HIV positive individuals.
As the zero proves to be at the deepest part of the canyon of HIV and AIDS fight, retaining girls in schools is a magic of accelerating efforts of reaching there. Dr. Nicholas Muraguri from the Ministry of Health Kenya will tell you that there is no better vaccine of preventing HIV infection, early pregnancies and marriages than keeping girls in school! NOPE will say that the power of peer education will accelerate the effectiveness of the above vaccine as I add my new voice by saying that targeting potential sexual partners with HIV preventive messages for the said girls will work wonders!
Dr. Ernest Nyamato made a plenary presentation about DREAMS that showed hope of moving towards zero on the domains of HIV prevention and treatment. In deed 90~90~90 goals are being accelerated in Kenya. I was made to understand that DREAMS aims at ensuring that Condoms are effectively utilized, Prevention of Violence and post violence care for young women is a reality in Kenya, HIV counseling and testing will be a right for every targeted population, Contraceptive method mix is inscribed in all sexual and reproductive health interventions for women and men, Social Asset building will be a reality, Reducing risk of sexual partners becomes a norm, Strengthen families fuels to journey towards zero, Mobilize communities for change contributes the 2020 goal for having community driven HIV response among others. Will these dreams become a reality?
If Kenya’s ambitious plan of having all HIV services being driven by the community by 2020 is to go by, then empowerment of the members in the lowest segment of the community hierarchy and relevant policies be legislated and implemented. By the way how about focusing on and empowering Kenya’s community strategy on achieving this?
Let all of us hold hands together for an HIV free generation in future!