Funding cuts impact HIV care for communities in Kenya

Vincent Okonya, head of programs at the Rural AIDS Prevention and Development Organization in Migori, said its USAID-funded program, implemented through PATH Kenya, supported 6,604 orphans and vulnerable children, including 2,733 children and adolescents living with HIV and about 348 HIV-exposed infants.

The program supported treatment adherence, followed up on children with unsuppressed viral loads and helped families meet school, nutrition and livelihood needs.

When funding ended following the January 2025 stop-work order, the organization laid off program staff members and transferred care services to government health facilities and the State Department of Children Services.

Okonya said the loss of community follow-up has left families struggling to meet basic needs and maintain children's treatment routines.

Desmond Otieno, program manager at the Integrated Development Facility in Homa Bay, said his organization had transferred care responsibilities to the subcounty hospital.

Before funding was withdrawn, the program served about 28,000 people across Homa Bay, Vihiga and Nyamira counties. Its focus has since narrowed to about 4,000 children living with HIV, while its workforce fell from 68 to 14, he said.

"A child coming from a poor household who can't afford food can't take drugs. USAID funding was giving economic support to some of the caregivers to buy food," he said.

Otieno warned that prolonged funding constraints could reverse progress in reducing HIV infections.

About 1.5 million people are living with HIV in Kenya, according to the 2026 estimates by the National Syndemic Diseases Control Council. Nairobi County has the highest number, at 189,907, followed by Homa Bay with 129,087, Kisumu with 115,147, Siaya with 96,439 and Migori with 80,217.

County health officials are integrating HIV services into routine healthcare but acknowledge that government systems cannot immediately replace all the functions previously performed by donor-supported organizations.

In Homa Bay, Stephen Omondi, the county's AIDS and STIs (sexually transmitted infections) control coordinator, said the stop-work order affected programs for adolescent girls and young women, voluntary medical male circumcision, orphans and vulnerable children, mentor mothers and peer educators.

The DREAMS project, which supported adolescent girls and young women through life skills and HIV prevention, was among the programs halted. More than 1,000 peer educators working with key and vulnerable populations were affected, Omondi said.