Exclusive: USAID says no Kenya HIV medication deal

A spokesperson for the U.S. Agency for International Development told Devex on Thursday that a large shipment of HIV medication stuck in diplomatic limbo has not yet been released — despite remarks made Wednesday by Mutahi Kagwe, Kenyan Cabinet secretary for health.

The Kenyan government has been in a stalemate with USAID over a large batch of antiretroviral treatment and other donated health supplies that have been stranded at the Port of Mombasa since mid-January. The issue under dispute is which entity will distribute the drugs: Kenya Medical Supplies Authority or the U.S.-based private company Chemonics.

Because of this, HIV treatment for the 1.2 million HIV-positive people living in Kenya is running “dangerously low,” as Devex previously reported. Treatment for children and lab reagents for testing HIV in babies are already out of stock. Most counties lack tuberculosis tests as well.

On Wednesday, Kagwe told the Kenyan National Assembly’s Health Committee: “The commodities have already been released to the country. That issue has been resolved.”

He added that “the U.S. government actually agreed that we use the system that we have been using in the past for distribution.”

But according to a USAID spokesperson, the medication and medical supplies “that were stuck at Mombasa Port remain in USAID’s possession until our deliberations conclude.”

While Kagwe’s remarks suggested the shipment donated by USAID was released from the port, the U.S. agency clarified the medications that were released this week are from another donor — the Global Fund to Fight AIDS, Tuberculosis and Malaria — and not from USAID. The Kenyan government made an arrangement with the Global Fund to support the country with drugs for the next three months. This arrangement is seen by civil society organizations as a Band-Aid measure that doesn’t lead to a return to multimonth dispensing of the drugs.

As the largest contributor to the Global Fund, the United States is also a donor of the medication released this week, but it is not the same supply of drugs under dispute with USAID.

USAID and Kenya Medical Supplies Authority had a five-year contract that ended in 2020. USAID then asked the Global Health Supply Chain - Procurement and Supply Management — implemented by Chemonics and a consortium of partners — to procure HIV, malaria, and family planning commodities for Kenya instead of KEMSA. Last year, KEMSA faced allegations of corruption and mismanagement of COVID-19 funds. Kagwe said USAID decided to not use the state corporation for distribution of the HIV drugs because it did not trust KEMSA.

In response, the Kenyan government initially demanded 90 million Kenyan shillings ($829,000) in importation taxes on the drugs, saying it wasn’t a tax-exempt government-to-government donation, but has since waived these. According to civil society organizations, though, the government is still insisting the drugs be delivered through its own system and not USAID’s private partner, creating the ongoing impasse.

Kagwe said the Kenyan government was actively working to address USAID’s “lack of trust” in KEMSA by “making changes in the organization that we are sure are going to satisfy the U.S. government and USAID.”

Update, April 22, 2021: This article has been updated with new details and quotes from Mutahi Kagwe.