Food shortages in arid, remote northern Kenya are making it impossible for HIV-positive people in the region to adhere to their antiretroviral (ARV) medication regime, relief workers say.
The life-prolonging ARV drugs have been labelled "death drugs" because of the effect they have on patients who take them without adequate food, according to Ahmed Mohamed Patel, a volunteer with the Kenya Red Cross in Isiolo, in Kenya's Eastern Province, which borders Ethiopia in the far north of the country.
"The safety and effectiveness of the drugs depends on the food intake ... unfortunately, most of the victims are poor and cannot afford a simple bite of food," he told IRIN/PlusNews. "The expected relief and intended assistance will never be achieved unless the problem is addressed."
Health workers said many HIV-positive people were opting to stay off the drugs rather than suffer the side effects of taking them on an empty stomach. The government has initiated a free food programme to assist families of people infected and affected by HIV in Isiolo but, so far, only 30 families have been benefiting.
"The food assistance programme is a big relief to the poor and their families; we know there are many deserving cases, but cannot assist all of them," said Isiolo district commissioner Evans Ogonkwo. "We are planning to expand and help more people."
Galma Aliof, of Isiolo Youth against AIDS and Poverty, a non-governmental support group, alleged that corrupt officials affiliated to the organisations providing free food have been selling the food supplements rather than giving them to needy families.
"Some of the officials heading these organisations are using this sad situation to make money ... they sell food openly," he said. "The other day an HIV-positive person died at Kulamawe village [near Isiolo], and yet a food store next to his house was filled with food."
Health workers have also complained that ARVs have not been reaching all those who need them. Although the government has been distributing free ARVs nationally for more than a year, many areas in the north, other than the main towns, are not served by a road network and have no access to the life-prolonging drugs.
Need to decentralise HIV services
"Infected persons have to travel to the district headquarters in case they need the drugs; it is expensive and many would rather not make the trip," said Sofia Shano, an HIV/AIDS counsellor in Isiolo.
Even where health facilities existed in remote areas, there was no electricity to store drugs that needed refrigeration. "Health centres in remote areas must be equipped with solar panels [to generate electricity for refrigeration] to help store the drugs," Shano said.
Margaret Leshore, patron of the Samburu East Women's Empowerment Programme, a non-governmental organisation advocating women's rights, told IRIN/PlusNews that all HIV programming, including testing, advocacy and treatment, needed to be taken to "the grazing fields, livestock market and watering points", where the region's mainly pastoralist communities could easily be found.
Although northern Kenya has some of the country's lowest HIV-prevalence rates, the region also has very low levels of awareness, and the nomadic lifestyle of its inhabitants means HIV service providers must find innovative ways of reaching all the area's resident with their messages.