Condom conundrum: Kenya's dangerous gamble with HIV

Kenya requires an estimated 400 million condoms annually to keep the HIV epidemic in check. [Courtesy] For a country battling a high HIV prevalence rate, Kenya's decision to tax condoms is nothing short of a public health catastrophe. This bureaucratic folly, wrapped in misguided fiscal policy, threatens to unravel decades of progress in the fight against HIV/Aids. At a time when every weapon in the arsenal is needed to contain the virus, the government's insistence on making condoms less accessible is akin to banning fire extinguishers in a city prone to infernos. Kenya requires an estimated 400 million condoms annually to keep the HIV epidemic in check. Yet, thanks to taxation and bureaucratic inertia, only about 150 million are being distributed. That leaves a gaping deficit-a shortfall that translates to millions of unprotected sexual encounters, a spike in new infections, and an inevitable burden on the already strained healthcare system. In 2022 alone, Kenya recorded 22,000 new HIV infections, those numbers will only rise if access to condoms continues to shrink. The government's defence? Revenue generation. In its infinite wisdom, the Kenyan treasury classified condoms as medical devices subject to taxation, ostensibly to plug budget deficits. But taxing condoms to raise funds is the fiscal equivalent of burning your house down to stay warm. The cost of treating an HIV-positive patient on antiretroviral therapy for life far outweighs the pennies collected from condom taxation. The math is not just bad-it's negligent. International donors, who have long been the backbone of Kenya's HIV prevention efforts, are growing fatigued. The Global Fund and USAID, once generous benefactors of free condom distribution, are scaling down their support. The government's response? Impose taxes on the very commodity that could keep new infections at bay. It is a public health policy designed by those who have never had to choose between buying food and buying protection. A pack of three condoms in Kenya now is now almost out of reach for the ordinary mwananchi. For a country where over a third of the population lives on less than Sh200 a day, this is an absurd luxury. Young people, who account for the bulk of new infections, are forced to engage in risky behaviour simply because protection is out of reach. The situation is even more dire in rural areas, where supply chain issues and stigma further compound the crisis. The Aids Healthcare Foundation (AHF) has been vocal about the disaster in the making, having warned that unless the government removes barriers to condom access, Kenya will witness a resurgence of HIV cases reminiscent of the 1990s. The warning is dire, yet policymakers remain unmoved, choosing instead to indulge in boardroom debates while the virus spreads unabated. In the face of the condom crisis, the government has shifted focus to pre-exposure prophylaxis (PrEP)-a daily pill that reduces the risk of contracting HIV. While PrEP is an invaluable tool in the fight against HIV, it is not a substitute for condoms. Unlike condoms, PrEP does nothing to prevent other sexually transmitted infections or unintended pregnancies. Relying solely on PrEP is like issuing bulletproof vests while banning helmets-protection against one danger while leaving people vulnerable to others. The government's push for PrEP at the expense of condoms reeks of short-term thinking. PrEP uptake in Kenya remains low due to stigma, misinformation, and the burden of daily adherence. Condoms, on the other hand, are simple, effective, and widely understood. Rather than creating an either-or scenario, the government should be championing a dual approach: Promoting both condoms and PrEP to ensure maximum protection. We should also be wary of reversing behaviour change gains made over years through safe sex campaigns that have normalised the use of condoms for protection. Kenya must do better. First, the government should immediately scrap taxes on condoms. The argument that taxation raises revenue is as absurd as it is deadly. If anything, the cost of inaction-rising HIV infections, increased healthcare spending, and lost productivity-far outweighs whatever peanuts the taxman hopes to collect. Second, funding for condom procurement must be prioritised. The government cannot continue to rely on dwindling donor support while dragging its feet on domestic investment. The public health budget should reflect the urgency of the HIV epidemic, ensuring that condoms are freely available in health centres, universities, and hotspots where they are needed most. Third, a robust public awareness campaign must be launched to reinforce the importance of condom use. The shift towards PrEP should not sideline the messaging around condoms. Instead, an integrated approach-promoting both PrEP and condoms-should be adopted to ensure Kenyans are fully protected. Finally, political will is essential. Policymakers must recognise that the HIV epidemic is not an abstract problem-it is a crisis affecting real people, with devastating consequences. The country cannot afford to treat condoms as mere commodities; they are a public health necessity. If Kenya is serious about eradicating HIV/Aids, it must stop treating condoms as a cash cow and start treating them as a lifeline. Anything less is reckless endangerment.

Condom conundrum: Kenya's dangerous gamble with HIV

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