(Daily Nation) – For years, in various counties, small, low-profile HIV clinics operated almost like a separate world within Kenya’s health system, funded not by the National Treasury but by the United States government, and built, deliberately, to keep a distance from the stigma that still surrounds an HIV diagnosis in many communities. Patients would sometimes travel for hours, picking up their antiretroviral drugs in a different town from where they lived, precisely so that no one at home would know. Community “link assistants” ferried medication to households too afraid to be seen at a facility at all.

That system, largely funded through USAid and the US President’s Emergency Plan for Aids Relief (Pepfar), has now been dismantled through a slow, uneven absorption into Kenya’s mainstream public health system that front-line workers say has left patients with less privacy, less time and, in some cases, no clear programme to belong to at all. (Read More)