Tuberculosis (TB) continues to be a significant global health threat, now ranking as the most infectious killer disease worldwide, surpassing HIV/AIDS in mortality rates. Experts caution that without increased awareness and renewed political commitment, Kenya may fall behind in the efforts to eliminate TB by 2030.
Against this backdrop, TB champions and other stakeholders gathered in Nairobi this week for the Second Kenya National TB Champions Summit. This forum unites TB champions and experts in TB advocacy to exchange ideas and discuss challenges, facilitating the identification of gaps in current interventions and the adoption of more effective improvements.
Philip Nyakwana, a member of the Kenya Coordinating Mechanism for the Global Fund, TB, and HIV, and a TB champion for over a decade, agrees that bringing together all stakeholders is key to improving healthcare services.
He notes, “This forum unites TB champions from all 47 counties to discuss TB care and management, primarily through advocacy. Such a forum generates important information used in decision-making.”
The theme of the event, “Empowering TB champions for a TB-free Kenya,” resonates well with the global target of ending TB by 2030.
Evaline Kibuchi, Chief National Coordinator of Stop TB Partnership Kenya and a TB advocate, acknowledges that political commitment is crucial for Kenya, as well as for global efforts, to achieve this target.
“TB has overtaken HIV in mortality rates both in the country and globally, making TB the most infectious killer disease. I long for the day when the president will stand on a podium and declare that we are losing people to a treatable disease, committing to leadership in addressing this problem. That is where political commitment will begin,” she states
Kibuchi further emphasises that managing tuberculosis (TB) should be a collective responsibility, extending beyond healthcare workers and civil society. For the desired outcomes to be realised, involvement from all sectors and communities is essential.
“Until we educate 50 million Kenyans about the basic symptoms of tuberculosis and the consequences of not seeking treatment, we will never win this war. The only way we can achieve this is through sustained education via media and social media to create awareness,” he says
She further notes that funding remains a significant challenge, as counties do not allocate money for tuberculosis (TB) treatment. Instead, they leave this responsibility to the national government, despite the devolution of health services.
“Domestic funding for the TB response is only 34%, while donor funding accounts for about 66%. With shrinking donor funding, what will happen if the donors withdraw, yet the government only commits 34%?” she asks.
Philip Nyakwana, a member of the Kenya Coordinating Mechanism for the Global Fund, TB, HIV, and a TB champion, points out gaps in the management of commodities, including drugs. He underscored the need to audit the drugs supply chain to avoid wastefulness.
“We still have a challenge in how we manage our commodities. For instance, if you have a short expiry and a large consignment of drugs in the warehouse or KEMSA, is there a problem with the distribution? This is wasteful, as you still incur costs to destroy expired drugs. We are engaging to see how to avert such occurrences or wastefulness,” he laments.
Nyakwana also notes that the issue of paediatric drugs for children remains a significant challenge, to the extent that children are given adult drugs broken into different sizes depending on the dosage. He states that this undermines progress, as an illiterate woman in the village may not know how to measure the dosage, and hygiene when handling the drugs may be questionable.
As Kenya transitions from the National Health Insurance Fund (NHIF) to the Social Health Authority (SHA), experts are worried about the coverage of drug-resistant TB patients under the new medical scheme.
“Initially, we had support for drug-resistant TB patients through the former medical scheme, NHIF, but now that we have moved to the Social Health Authority, we don’t know if such patients are covered under SHA or what will happen,” laments Nyakwana.
Kibuchi further outlines nutrition as an important aspect of TB prevention and treatment; yet, there is limited nutritional support for TB patients.
“Malnutrition is a vulnerability to TB, it is one of the factors that pre-disposes someone to TB. Once you start treatment, for one to spring back, they need proper nutrition, but this has been a challenge especially because of poverty and lack of awareness.’ She calls on government and other stakeholders to come on board and support nutrition programs for TB patients,” she says
Experts emphasise that community engagement is crucial for effective TB response interventions, as TB patients spend the majority of their time in the community. Involving communities in TB initiatives raises awareness and brings attention to urgent issues, such as stock shortages of TB medications. They urge the government to acknowledge and support those who champion TB awareness.
