Health experts warn of a possible surge in HIV infections in 13 counties in Kenya following reduced uptake of Voluntary Medical Male Circumcision (VMMC) which reduces chances of contracting HIV by up to 60 per cent, turning VMMC into one of the biggest boosts against HIV.
By the end of last year, 2.3 million adolescent boys and men had faced the cut, according to NASCOP (National Aids and STIs Control Programme).
But now gains made are gradually being eroded after the biggest donors of VMMC withdrew. The pandemic not only saw donors diverting funds, but fewer people reported to hospitals. The pandemic also saw a reduction in selective surgeries of which VMMC is part.
VMMC programme manager at NASCOP, Ambrose Juma, says reduced funding from PEPFAR (President’s Emergency Plan For AIDS Relief) is the main reason for reduced uptake which has seen numbers dwindle by 72.5 per cent from 900 monthly male cuts in Kisumu to an average of 60. Countrywide, the numbers reduced from 200,000 annually to 55,000, and it all began in March 2019, when former US President Donald Trump, cut PEPFAR funding by $1.35 billion (Sh135 billion) - the largest reduction such reduction since PEPFAR began in 2003, according to HealthGap.
In August 2020, PEPFAR stopped sponsoring VMMC for Kenyan boys aged 14 years and below, who comprised 60 per cent of the annual beneficiaries, but continued funding the cut for the 15-49-year-olds.
Juma says PEPFAR cited safety and human rights concerns and this left “a significant resource gap for the VMMC programme, which is a serious threat to its sustainability.”
Joel Olilo, NASCOP VMMC Focal Person in Kisumu, said 30 health facilities have reduced staff to six from 24 due to shrinking client numbers and “we are afraid if the uptake will reduce further, there are chances that infections will rise.”
PEPFAR has supported VMMC in 15 countries in southern and eastern Africa and has reached more than 22 million adolescent boys and men with a resultant decline in HIV prevalence over time.
In Kenya, it benefited traditionally non-circumcising communities mainly in Kisumu, Siaya, Homa Bay, Migori, Turkana and Busia counties. Seven culturally-circumcising counties of Nandi, Kericho, Nairobi, Nakuru, Mombasa, West Pokot and Marsabit, which have a significant number of immigrant non-circumcising communities, also benefited.
NASCOP now reckons the national and county governments should prioritise funding VMMC as the current situation could lead to a surge in HIV infections if not addressed.