STAR ILLUSTRATION
Something that has impressed me most profoundly over the years, is the capacity of families to recover from adversity.
The kind of thing I have in mind is when, for example, the father in a middle-class family with three young children dies in a car accident and only then does the family find out that, far from having any savings to speak of, the man was drowning in debt and only managing to keep things going with the greatest difficulty.
Suddenly, they can no longer afford the rent or mortgage for their nice apartment; they cannot afford the private schools the children were accustomed to; they definitely can no longer afford a car; and they have to make dozens of other humiliating reductions to their standard of living.
But the story does not end there.
After a token fundraiser to “help with funeral expenses,” most of their friends lose touch with the bereaved family. And then, a dozen or so years later, you suddenly find the mother, accompanied by one of her children, calling on you to say that the young man or woman has just finished college, and – as a close friend of their late father – would you please help them get a job?
In short, the family has somehow managed to pull through – largely by their own efforts, and by making immense sacrifices – and ended up more or less where they would have been if the father had not died in that accident.
This is the perspective I would like to bring to the sudden and cruel loss of funding for HIV-Aids interventions which largely came under USAID’s President’s Emergency Plan For AIDS Relief – Pepfar: funding that it is now clear is never coming back.
It need not be the end of the world, for those long accustomed to the free antiretroviral drugs programmes which USAID had supported for about 20 years now.
With a little belt-tightening, Kenya can manage without any USAID funding for these landmark HIV-Aids programmes.
I would advance two major reasons for this view: First, the cost of ARV drugs is not what it used to be. In the early days of the HIVAids pandemic, and at a time when being infected with the virus was a death sentence for ordinary Kenyans, the kind of sums whispered in private as the cost of these miraculous life-saving drugs was a million shillings a year.
In fact, they cost more than that – it was closer to Sh3 million a year to be on the initial ARV drugs.
Nowadays, with most ARVs being generics manufactured in India, the cost is as low as Sh3,000 a month (ie, Sh36,000 a year). This is not peanuts to most Kenyan families but should be affordable with support from the national health insurance institutions.
Second is that the elaborate public health infrastructure that Pepfar helped to create did not vanish as soon as US President Donald Trump signed the executive order which was the first step towards dismantling USAID.
The infrastructure still exists for the distribution of ARVs throughout the country, as well as the provision of the support services which are part of any comprehensive public health initiative. And it would cost far less to operate this public health infrastructure if the Kenyan government were running it.
The kind of NGOs that served as “contractors” under USAID projects, were well known to pay some of the best salaries in Kenya. Government jobs – for much the same kind of work – paid less than half of what those NGOs paid.
Consider this: If you were one of those reported 40,000 Kenyans who have lost their jobs because of the abrupt withdrawal of funding by USAID, and the government of Kenya offered you the same job back but at approximately 40 per cent of your previous salary, would you or would you not take it?
My point is that if we have the staff as well as the drugs needed for the public health programmes that lead the fight against HIV-Aids; and since they would cost us far less than what USAID used to spend on running these very programmes; why then should we consider this to be an insurmountable disaster?
Wycliffe Muga is a columnist
