Kenya

HIV/AIDS epidemiological summary

HIV information among antenatal clinic attendees has been available from Kenya since the mid-1980s. In Kenya, the major urban areas are Nairobi and Mombasa. HIV information has been available from Nairobi since 1985 and from Mombasa since 1990. In the major urban areas, HIV prevalence among antenatal women tested increased from 2% in 1985 to 19% in 1995. In 1995, HIV prevalence reached 25% in Nairobi. In 1997, 16% of antenatal clinic attendees in Nairobi tested HIV-positive. HIV prevalence among the same group tested 12% in Mombasa in 1994 and increased slightly in 1997 to 14%. No age breakdown is available. Outside the major urban areas, HIV information became available in 1988 from Machakos and Kajiado in 1989. By 1990, 12 sentinel surveillance sites were reporting HIV information. Among antenatal clinic attendees tested in these sentinel surveillance sites, median HIV prevalence increased from less than 1% in 1988 to 13% in 1997. In 1997, HIV prevalence ranged from 6% to 35% among 15 sentinel surveillance sites. No age breakdown is available.

Information on HIV prevalence among sex workers in Nairobi has been available since the mid-1980s. In Nairobi, HIV prevalence among sex workers tested had already reached 62% in 1985 and increased to 86% in 1992. HIV information on sex workers in Mombasa was only available for 1989 and 1993-95. In 1993-95, 55% of sex workers tested in Mombasa were HIV-positive. Information on HIV prevalence among male STI clinic patients has been available from Nairobi since 1985. HIV prevalence among male STI clinic patients tested in Nairobi increased from 16% in 1985 to 28% in 1991-92. In 1996, 14% of STI clinic patients tested in Nairobi were HIV-positive. HIV information on male STI clinic patients from Mombasa is only available for 1994: 9% tested HIV-positive. Among female STI clinic patients tested in Nairobi, HIV prevalence increased from 14% in 1989 to 29% in 1998.

Estimated number of people living with HIV/AIDS, end 1999	Adults and children	Adults (15-49)	Adult rate (%)	Women (15-49)	Children (0-14)
Source: UNAIDS/WHO, June 2000	2 100 000	2 000 000	13.95	1 100 000	78 000
Demographic impact of HIV/AIDS		Year	Estimate	Source
Children who lost their mother or both parents due to HIV/AIDS at age 14 or younger since the beginning of the epidemic		1999	730 000	UNAIDS/WHO, June 2000
Estimated AIDS deaths		1999	180 000	UNAIDS/WHO, June 2000
Behavioural indicators		Year	Age group	Male	Female
Reported condom use during most recent intercourse with non-regular partner (%)		1998	15-49	42.5	15.1
Reported non-regular sexual partnership over a 12-month period (%)		1998	15-49	19	5
Measured HIV prevalence		Year	Median	Min.	Max.
Women in antenatal care clinics - major urban areas (%)		1997	15.2	14.4	15.9

Figure

Economic impact of HIV/AIDS

Summary of the economic impact of HIV/AIDS

Data on the economic impact of AIDS on Kenya are relatively extensive, compared with many other countries in sub-Saharan Africa. In particular, a study carried out by AIDSCAP/Family Health International has provided extensive data to help with planning and policy decisions in each of the sectors. Of the sectors explored here, the studies in health demonstrate that the health system is being stretched by the need to care for people with AIDS, and there is still a large gap in funding for a scaled-up care and prevention programme, equivalent to 1.2% of GDP. Studies in the area of business and agriculture are still limited but show costs in terms of reduced labour time and increased medical and burial costs. Finally, there is little work in the area of education and more detailed studies are required to understand the full impact on this sector, in order to shape responses appropriately.

Macroeconomic impact

An early model of the economic impact of AIDS in Kenya predicted a reduction in GDP of 14.5% by 2005 (1). Preliminary results of a model developed in 2000 estimate the annual loss in GDP growth per capita as a result of AIDS to be 1.3% by 2010 (2).

Economic impact of HIV/AIDS on households

Households are estimated to lose 49%-78% of their income when one person dies from AIDS (excluding funeral costs) (3).

Economic impact of HIV/AIDS on agriculture

On an agro-estate in Nyanza Province, costs due to AIDS-related funerals between 1992/93 and 1998/99 tripled (4).

Economic impact of HIV/AIDS on firms

Supply: In a study of six firms in 1994, the AIDS-related loss in profit varied between 0% and 6% (1.7% on average). The projected increase in AIDS-related profit loss for 2005, in those same firms, was calculated to be 0-14% (4% on average) (5). In a separate survey of four firms, the annual cost per employee with AIDS was found to be between US$ 17 and US$ 49 (6), (7) and (8) cited in (9).

Economic impact of HIV/AIDS on education

Supply: A model developed by UNAIDS and UNICEF in 2000 shows that, of around 5.6 million primary school students, 95 000 would have lost a teacher to AIDS in 1999 (10).

Demand: Not available

Economic impact on the health sector

Supply: Not available

Demand: Bed occupancy rates for HIV/AIDS-related diseases is 30% in major central hospitals and between 10% and 30% in district hospitals (11).

Resource gap: The annual cost of scaling-up HIV/AIDS programmes is estimated to be between US$ 78 million and US$ 125 million (2).

Management and implementation of the national response to HIV/AIDS

Policy formulation

Existence of national HIV/AIDS policy (either a written document or part of one)

Yes	No
X

Comments/Key elements: Sessional Paper no 4 of 1997 on AIDS in Kenya, Ministry of Health/Republic of Kenya

Source: The National AIDS Control Council

Date: June 2000

Existence of HIV/AIDS policy in the following sectors:

Sector	Yes	No
Agriculture		X
Education		X
Health		X
Military		X
Workplace		X
Sports		X
Others		X

Comments/Key elements: Efforts are under way to establish mainstream HIV/AIDS programmes, where necessary, and to retrofit HIV/AIDS programmes in the concerned ministries.

Source: The National AIDS Control Council

Date: June 2000

Existence of HIV/AIDS-specific legislation against discrimination on the grounds of HIV

Yes	No
	X

Comments/Key elements:
Source: UNAIDS Kenya
Date: June 2000

Organizational structure

Existence of high-level structure in support of the national response

(e.g. National AIDS Committee/Commission, Inter-Ministerial Committee, Presidential-level bodies)

Yes	No
X

Comments/Key elements:

The National AIDS Control Council

Following the Presidential address in December 1999, declaring AIDS a disaster, a National AIDS Council was created by Presidential decree. The National AIDS Council is located at the office of the President and consists of Permanent Secretaries, NGOs, associations of people living with HIV/AIDS and representatives of private sectors. The Chairman of the National AIDS Council is Dr Abdalla Mohamed. The Chairman of the National AIDS Council reports to the Minister in charge of Presidency and Internal Security, Mr Madoka Masden.

The Kenya HIV/AIDS Consultative Group

This is a forum that includes heads of UN agencies, bilateral donors, the Government of Kenya, People Living with HIV/AIDS, representatives of private sectors, NGOs and religious organizations. The objectives of the Kenya HIV/AIDS Consultative Group are defined as follows: priority-setting, advocacy and promotion of multisectoral approaches, information sharing, and promotion of regional and international initiatives and actions recommended by the Technical Working Group. The Government of Kenya, with the UNTG as the secretariat, chairs the HIV/AIDS consultative group.

Source: UNAIDS Kenya

Date: June 2000

Planning and programming

Existence of national strategic plan on HIV/AIDS

Yes	No
X

Comments/Key elements: The strategic planning process, which started in 1998, was completed in 1999 when the Strategic Plan for the Kenya National HIV/AIDS & STD Control Programme, 1999-2004, was completed. The plan is being reviewed and re-costed.

Source: Strategic Plan for the Kenya National HIV/AIDS & STD Control Programme, 1999-2004

Date: June 1999

National strategic plan on HIV/AIDS includes clearly identified priorities

Yes	No
X

Comments/Key elements: Seven key initiatives are presented in the national strategic plan as priority components:

Advocacy and promotion of behaviour change
Blood safety
Continuum of care and support
Treatment and control of sexually transmitted diseases
Epidemiology and research
Prevention of mother-to-child transmission of HIV
Mitigation of the socioeconomic Impact

Source: Strategic Plan for the Kenya National HIV/AIDS & STD Control Programme, 1999-2004

Date: June 1999

Existence of budget for implementation of the national strategic plan

Yes	No
X

Comments/Key elements: There is a budget (US$ 33 million) for the implementation of the Strategic Plan. However, this budget is currently being reviewed and re-costed. Current estimate is US$ 187 million over the period 1999-2004.

Source: The National AIDS Control Council/UNAIDS Kenya

Date: July 2000

General demographic and socioeconomic indicators

Demographic indicators	Year	Estimate	Source
Total population (thousands)	1999	29 549	UNPOP
Population aged 15-49 (thousands)	1999	14 261	UNPOP
Annual population growth (%)	1990-1998	2.6	UNPOP
% of population urbanized	1998	30	UNPOP
Average annual growth rate of urban population (%)	1990-1998	5.4	UNPOP
Economic indicators	Year	Estimate	Source
GNP per capita (US$)	1997	340	World Bank
GNP per capita average annual growth rate (%)	1996-1997	0.4	World Bank
Human development index rank (HDI)	2000	138	UNDP
% population economically active	-	43.3	ILO
Unemployment rate	-	-	-
Education indicators	Year	Estimate	Source
Total adult literacy rate	1995	78	UNESCO
Adult male literacy rate	1995	86	UNESCO
Adult female literacy rate	1995	70	UNESCO
Male secondary school enrolment ratio	1996	25.7	UNESCO
Female secondary school enrolment ratio	1996	21.8	UNESCO