A Question of Life or Death - Human Rights Watch

egular health system and create separate, HIV-specific structures. But for HIV goals
to be met, broader health systems must also be strengthened. 54
Donors have funded much of Kenya’s fight against HIV. In 2006, based on
conservative estimates, about 34 percent of Kenya’s HIV/AIDS-related funding came
from external sources 55 (several analysts estimate the percentage of donor funding in
HIV services to be significantly higher 56 ). The most important donor in Kenya for
health is the United States, through the President’s Emergency Plan for AIDS Relief
(PEPFAR). During 2007 PEPFAR funding was over US$368 million, 57 exceeding the
government’s own contributions toward HIV/AIDS of about US$282 million in 2007.
Another important donor is the Global Fund to Fight AIDS, Tuberculosis and Malaria.
It has approved HIV grants totaling nearly US$130 million 58 and in November 2007
disbursed US$70 million to Kenya. Before that, Kenya had failed to obtain approved
Global Fund aid because of delays and mismanagement. 59 Corruption has also been
a major problem within the NACC, whose first director had to step down as a result. 60
Other important donors include the United Kingdom, Japan, Germany, and several
multilateral agencies, such as UNICEF, the World Bank, and the European Union
54 Gorik Ooms et al., “The ‘diagonal’ approach to Global Fund financing: a cure for the broader malaise of health systems?”
Globalization and Health, 2008, vol 4:6, http://www.globalizationandhealth.com/content/4/1/6 (accessed November 11,
2008); Dongbao Yu et al., “Investment in HIV/AIDS programs: Does it help strengthen health systems in developing
countries?” Globalization and Health, 2008, vol 4:8, http://www.globalizationandhealth.com/content/4/1/8 (accessed
November 11, 2008).
55 Govender, McIntyre, and Loewenson, “Progress towards the Abuja target for government spending on health care in East
and Southern Africa,” p. 15.
56 Human Rights Watch interview with James Kamau, KETAM, August 6, 2007; “Kenya's Dependency on Donor Funding
Affecting Fight Against HIV/AIDS, NGO Consortium Head Says,” The Body: The Complete HIV/AIDS Resource,
http://www.thebody.com/content/news/art44371.html (accessed November 11, 2008); John Kamigwi et al., “Scaling Up the
Response to HIV and AIDS in Kenya: Mainstreaming through the Government Budget Process,” Constella Futures, March 2006,
http://www.constellagroup.com/international-development/resources/cf_mtef.pdf (accessed October 15, 2008).
57 United States President’s Emergency Fund for AIDS Relief (PEPFAR), “Kenya FY 2007 Country Operational Plan (COP),”
http://www.pepfar.gov/about/82449.htm (accessed September 15, 2008).
58 Ibid.
59 Kenya had failed to submit audited accounts for past grants or delayed grant reports. See Wairagala Wakabi, “Kenya’s
mixed HIV/AIDS response,” The Lancet, vol. 369, issue 9555, January 6, 2007, pp. 17-18.
60 Transparency International, Global Corruption report 2006. Corruption and Health (London/Ann Arbor: Pluto Press, 2006),
pp. 112-115.
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