FUNDING FOR TUBERCULOSIS CONTROL IN KENYA
Kenya remains in the list of High TB Burden Countries that contribute 80% of the total TB global burden, and is ranked fourth in Africa after South Africa, Nigeria and Ethiopia. In 2010, the country was recognized by WHO for its efforts in TB control and becoming the first country in Africa to meet the WHO targets for Case Finding and Treatment Success rates. Since then, the country has been making progress towards eliminating TB by investing in efforts to increase case detection and treatment success rates among other TB indicators.
The GOK has continually supported procurement of first line anti TB medicines to the tune of 60% (about Ksh. 280m) with the donors (World bank, Global Fund, USAID) supporting the other 40%. The Country had built adequate stocks of buffer for the first line anti-TB medicines such that as at July 2013, we had approximately 12 months’ worth of buffer stock at national level.
The National TB control program has continuously reported funding gaps each financial year.For instance in 2013 alone, there was a funding gap of 61% of the total required funding for that year .(See table below). In addition to this deficit, it is sad to note that there was no allocation for TB first line drugs in the FY 2013/2014. This seems to be a trend with the same happening in the FY2014/2015 on the basis that TB drugs procurement is the responsibility of development partners.
As a result, the country ran out of stock of first line TB drugs in March 2014. This was after missing a cycle of procurement for 2013/ 2014 and utilizing all the buffer stocks. This forced the Government through the Ministry of Health to borrow the drugs from friendly neighbouring Malawi. A six months stock was given which is likely to run out in September 2014. This is just but a temporary measure which is not sustainable.
The TB program has written lots of correspondence to the Ministry of Health and Treasury citing the lack of allocation of funds for procurement as a factor that will lead to reversal of gains made in TB treatment success. A request was made for the supplementary budget in February 2014 to which an allocation was made. However, this was devolved to the counties with no instructions and guidelines on what to prioritize. The counties did not therefore procure the drugs. Procurement of TB drugs has been delegated to the counties, where there are no adequate systems for effective drugs procurement and for quality assurance. Similarly, it would be difficult for partners such as Global Drug Facility to fund counties directly.
If the issue of TB drugs stock outs is not addressed, the country is likely to experience increased cases of Drug Resistant Tuberculosis strain that is costing the country hundreds of millions to treat and manage.
The table below summarises the TB funding situation in Kenya:
Total annual funding required
100(55 Million USD
Domestic source( Government)
Source :( WHO report 2013)
Shortage in funds may lead to loss of lives as a result of patients not accessing essential TB services and treatment. This does not only derail attainment of health targets at the country level as well as the global level but also hampers development.
We ask FOR your support to ensure that
1. The Ministry of Health and County Governments urgently coordinate and to ensure procurement of TB first line drugs and other commodities is a priority.
2. The Government to commit to finance 100% of the first line TB drugs in the subsequent budgets
By Evelyn Kibuchi
TB advocacy project ManagerTB advocacy project Manager