Kenya’s new policy on domestic financing of HIV research

In Kenya an ambitious new target to increase national funding of HIV research sees the government expecting to raise about USD109 million from local sources over the next five years.

Kenya has launched an ambitious target to shift from overly relying on foreign financing to increase national funding of HIV research. The government expects to raise about USD109 million from local sources over the next five years.

Unveiled last month, the Kenya HIV and Aids Research Agenda (2014-2019) aims to increase domestic HIV research financing in the wake of diminishing external support. Kenya relies heavily on foreign donors to finance HIV AIDS projects (over 90 per cent of total in-country HIV research financing) and the newly launched policy is a major departure from this trend.

National Aids Control Council director general Dr Nduku Kilonzo said: “The agenda has identified high-impact research priorities including reducing new HIV infections by 75 per cent and AIDS mortality by 25 per cent. It will also aim to reduce HIV-related stigma and discrimination by 50 per cent while increasing domestic financing of the HIV response to 50 per cent.”

Why now?

The search for domestic funding of HIV research has been triggered by dwindling external financial support to fight HIV. It is a pressing concern for the country. Currently, the Kenya Aids Strategic Framework predicts that 5.6 per cent of Kenya’s population of about 40 million people is living with HIV. The peak of 10.5 per cent HIV prevalence was between 1995-1996 and declined to 5.3 per cent in 2014. In 2003, there were 163,000 annual AIDS-related deaths, which reduced to 58,000 in 2013. So progress is being made.

The Kenya Bureau of Standards’ statistics reveal that new HIV infections are estimated to have declined by about 15 per cent in the last five years from about 116,000 in 2009 to around 100,000 in 2013. A combination of behavior change, prevention and treatment services and biomedical research have significantly contributed to such gains.

Right now, 90-95 per cent of Kenyan HIV research projects are funded by external donors and projections are that there will be a 20 per cent annual reduction in funding by 2019. This threatens scientific gains and the country’s goal of ending HIV.  Furthermore, investments in funding domestic research could yield five to eight times, while saving up to USD 130 million US dollars in the next five years.

How will it happen?

The new research agenda encourages domestic HIV and AIDS research financing through both short- and long-term strategies. It projects that up to 130 million US dollars could be saved over the next five years through efficiency gains, economic productivity gains and savings on antiretroviral costs. Under the short-term strategy, it will improve efficiency in HIV by scaling up behavioral change work. For long-term measures, it envisages sustainable investment and research in HIV and AIDS vaccines, microbicides and implementation of pre-exposure prophylaxis (PreP).

Dr Kilonzo said: “Given the financial gap, there is need for diversification of financing options, widening scope of stakeholders and offering returns on such investments. Due to foreign funding challenges, we need alternative sources like domestic money markets and public sector contributions among others.”

Dr Kilonzo added that all alternative domestic funding options are subjected to stringent feasibility studies. The options include government budgetary allocations, HIV tax levies across various industries, debt financing such as bonds and individual (informal) sector contributions.

Locally-driven research

The new policy takes account of the limited capacity among local Kenyan researchers, and the challenges they face to research the drivers of the epidemic and evaluate the effectiveness and efficiency of various interventions. Other challenges include limited engagement of researchers with policy needs and policy makers, resulting in a weak translation of research findings into policies and practices.

Allan Ragi from Kenya Aids NGOs Consortium argues that for the project to succeed, a minimum of two per cent of national GDP must be dedicated towards HIV research, with a clear roadmap for progressive implementation and accountability.  Allan said: “Such commitments need to be translated in national and county budget cycles and discussions. Policy frameworks need to increase domestic philanthropy and private-public financing.”

Accrding to Dr Jasper Rugut from the National Council for Science, Technology and Innovations, locally-funded research will immensely reduce Kenya’s HIV burden and he called for a coordinated mechanism for data sharing, transparency and coordination with national priorities.

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