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!