Job crisis looms as US slashes funding to HIV

 A civil society organisation takes part in a HIV campaign. [PHOTO: FILE /STANDARD]

Kenya: Thousands of jobs are at stake after the US Government implemented massive funding cuts to civil organisations in the health sector, especially those involved in the fight against HIV and Aids.

Already, hundreds of employees have lost their jobs because of budgetary cuts by the US President's Emergency Plan For Aids Relief (PEPFAR), which contributes about 90 per cent of the country's Aids funding, and the number is rising as many more groups shut down.

Last year alone, PEPFAR reduced funding by about Sh6 billion (US$69 million) and more than 500 non-governmental organisations (NGOs) dependent on the donor funding are scaling down their operations.

There are no official figures yet about the full extent of the job cuts but considering these NGOs run extensive networks with affiliates also dependent on the funding, the numbers are in their thousands.

The US Office of the Global Aids Coordinator had requested that Kenya reduce expenditures under the PEPFAR Country Operational Plan 2013 to a maximum of US$490 million down from US$529 million.

"The Americans have classified HIV activities as core, near-core and non-core, with funding reducing as you move from the centre," says Ms Ida Jooste, the head of Internews-Kenya, which this year lost a US$8 million four-year funding hence sending some workers home.

The core includes products such as medicines, condoms and testing kits while near-core are healthcare providers and the most outer layer, non-core, includes awareness creation, advocacy and capacity building.

Most of the 554 registered civil groups in the health sector are likely to be affected by the new US approach not only in the funding of HIV, but other areas such as malaria, tuberculosis and reproductive health.

Although the Economic Survey 2014 shows malaria and pneumonia to be the leading killers in the country, HIV is by far the highest funded disease in the country at Sh43 billion annually.

The budgetary allocation to the Ministry of Health in the current financial year is Sh47.4 billion.

According to the Kenya National Aids Strategic Plan III prepared by the National Aids Control Council (Nacc), the current Sh43.3 billion annual spend on HIV will jump to Sh92.9 billion within six years.

By 2019, Nacc says the country will be facing a HIV financing gap of Sh145 billion, growing to Sh215 billion by 2030.

At a meeting to review the Kenya National Aids Strategic Plan III held in Nairobi recently, the head of PEPFAR in Kenya Ms Katherine Perry scoffed at media reports that the organisation was cutting funding to the country.

She said they were not backing off and or pulling out their support and that they were still going to work hand in hand with the Kenyan Government.

According to the US Global Health Initiative which involves Kenya and another 29 countries, American money is now moving toward supporting the health sector in its totality as opposed to the prioritisation of a single disease.

"We are working with the government to put in place a strong health system that will be able to address the current and future needs of the people of Kenya," said René Berger the USAid team leader for Kenya on Wednesday.

But this policy is proving bitter for civil groups and community-based organisations (CBOs) now feeling the heat from the recent donor cuts to HIV.

For example, the umbrella Kenya Aids NGO Consortium (Kanco) with a membership of about 1,200 CBOs has lost substantial funding to some of its associates. (See separate story)

While the change in the funding direction was not entirely unexpected, Ms Everlyn Kibuchi, a senior official with Kanco, says what hit most was the abruptness of the PEPFAR directive.

"I had barely gone through probation before the sack for what was said to be reduced donor support," says a victim who had just resigned from another stable job in the private sector.

There is nothing the now tarmacking victim can do because a clause in the engagement contract says employment is only guaranteed as long as funds are available.

This abrupt, almost rude change of course midway may be explained by a new US foreign aid policy - Dollar to Results - adopted by USaid in the last few years.

The policy affects Kenya and another 78 other countries worldwide and targets to get more for every American dollar spent in foreign aid.

Last year, USaid says it carried out 257 evaluations of its global programmes, including in Kenya, which are helping them make smarter decisions.

"More than 50 per cent of completed evaluations informed the design of new projects or led to mid-course corrections," says USaid on its website.

A report prepared by UNAids and presented at the ongoing Aids conference in Melbourne, Australia, shows a declining support to HIV globally.

Last year, UNAids told delegates funding commitments fell by three per cent from 2012 levels.

"This was due to decreasing commitments by the US, the largest donor to HIV in the world."

Last month, Health Cabinet Secretary James Macharia told an international conference on HIV in Nairobi that this is not the time to scale down funding when the prevalence rates are on a decline.

 

Direct funding to the government from PEPFAR is indicated to have declined by about US$10 million this year from 2013 levels.

However, government HIV programmes are unlikely to suffer in the recent future with last month's injection of Sh43 billion from Global Fund.

But future assistance from the Global Fund may also suffer because US output is expected to decline by next year.

"Both the President and Congress have indicated that the 2015 contribution will decline by US$300 million – largely due to legislative requirements that the US provide no more than 33 per cent of the total contributions to the Global Fund," says the UNAids report.

Now civil groups and Nacc want the government to step in and close the developing funding gap.

Nacc is agitating for an autonomous authority that will lead the HIV fight through funding from special taxes and budgetary allocations.

Last week, civil groups demanded that government put more money in HIV because this, they said, is a constitutional right but just fell short of threatening court action.