The USA freeze on humanitarian funding has disrupted global medical supply chains, and one of the areas already feeling the effects is Nairobi and its surrounding cities and counties.
For example, a health clinic in Nairobi, the Kenyan capital, has been providing a month’s supply of antiretroviral drugs (for HIV) since the US government froze foreign aid, after previously providing patients with six months of treatment.
Meanwhile, on the outskirts of the city, millions of doses of antiretroviral drugs sit on the shelves of a warehouse, unused and inaccessible, even though the clinic is a half-hour drive from the warehouse.
Without U.S.A. funding, distribution from the warehouse that holds all of the HIV drugs donated by the U.S. government to Kenya has ground to a halt, leaving supplies of some drugs running low, a former USAID official and a health official in Kenya said.
The 90-day freeze on foreign aid ordered by the U.S.A. President Donald Trump, after taking office on Jan. 20, has disrupted the global supply chain for medical supplies to fight HIV and other diseases. It is also blocking the distribution of drugs that were long overdue in their destination countries.
“I just see death coming now!”
So says Alice Okwirry, 50 years old, who was diagnosed with HIV in 2008 and has a 15-year-old daughter, Chichi, who is also HIV-positive. Okwirry used to get her antiretroviral treatment for six months from the clinic, but now she can only get it for one month. She is moved to tears when she says she asked her daughter, Chichi, what would happen if they could no longer get their treatment: “Mom, I’ll rely on you,” the child replied.
HIV freeze exemption faces challenges
The State Department issued a statement last month exempting HIV treatment funding from the freeze.
But USAID’s payment system in Kenya has been struggling since the cuts, meaning contractors implementing the programs can’t get paid, says Mackenzie Knowles-Courchin, who was deputy communications director for USAID in East Africa until she resigned on February 3 in protest of the service’s elimination.
“Well, how am I going to continue operating if you’re not paying me?” says McKenzie, adding, “The exemptions that have been decided are, in fact, exemptions on paper only.”
Officials in Washington have not approved the release of the money needed in Kenya to distribute the $34 million worth of drugs and equipment in the warehouse, McKenzie said.
According to a Kenyan government document seen by Reuters, about $10 million is needed for the distribution. The Mission for Essential Drugs and Supplies (MEDS), the Christian charity that runs the warehouse, supplies drugs to about 2,000 clinics across the country, according to its website.
Reuters reports that the goods in the warehouse include 2.5 million bottles of antiretroviral drugs, 750,000 HIV testing kits and 500,000 malaria treatments.
USAID has requested a response from the State Department on the issue, but has never received one.
Kenyan Health Minister Deborah Barasa said she expects her government to mobilize funds to allow the supplies to be released to MEDS within two to four weeks. “We have identified the resources required,” she said in an interview.
Living in Fear
Kenya has the seventh-highest number of people living with HIV in the world, with about 1.4 million, according to the World Health Organization. The President’s Emergency Plan for AIDS Relief (PEPFAR), the main U.S. vehicle for funding HIV treatment, provides about 40 percent of HIV drugs and supplies in Kenya.
A health official in Kenya, who asked not to be named due to the sensitivity of the issue, said that stocks of two critical HIV treatments, Dolutegravir and Nevirapine, were low, but he did not know exactly how much remained nationally.
Dolutegravir is often used to treat HIV and tuberculosis co-infections. Nevirapine is often used to prevent mother-to-child transmission.
Kenya’s Health Minister Deborah Barasa said there would be enough Dolutegravir to last five months and Nevirapine to last eight months once MEDS’s stockpile is released.
Lawsuits seeking to force the Trump administration to restore funding for humanitarian programs and reinstate thousands of laid-off USAID workers are continuing in U.S. courts.
On Monday, Secretary of State Marco Rubio said the Trump administration had canceled more than 80 percent of all USAID programs.
The Kenyan government’s council on communicable diseases estimated in an internal briefing seen by Reuters last month that U.S. cuts had created funding gaps of about $80 million.
Finance Minister John Bundy told senators last week that the government was reviewing whether to provide emergency funding to offset cuts to US aid before delivering the 2025/26 budget in the coming months.